Perceptions, impact and management of asthma in South Africa: a patient questionnaire study.

INTRODUCTION A number of studies from around the world have indicated that asthma morbidity is still unacceptably high. In the AIRE study over one-third of children and half of the adults reported daytime symptoms at least once a week. This study was conducted to understand the impact (including the impact on health-related quality of life) of asthma on South African asthmatics. MATERIALS AND METHODS General Practitioners (GPs) and pharmacists in South Africa were randomly identified from the Medical Association database. These individuals were approached and asked to recruit asthmatic patients to complete a questionnaire. The questionnaire inquired about symptoms, quality of life, complications, trigger factors, associated allergic conditions, medication used, medication preference, medication adherence and concerns about the condition. RESULTS 3347 respondents returned their demographic data but only 710 met the criteria for analysis, ie. had asthma and were presently on controller medication. Symptom analysis revealed that 21.4% of respondents were coughing on most days, 25.6% were wheezing on most days, and 22.8% were experiencing night-time symptoms on most days. Symptoms were exacerbated by exercise in 56.9%, while nocturnal wakening due to asthma occurred in 36.9% more than four times per week. Only 35.1% of respondents had not missed school or work in the preceding year. 45.4% of individuals worry about side effects of asthma therapy. CONCLUSION This study indicates that there is under-treatment, inappropriate treatment and/or lack of patient education for asthma patients in South Africa. The data support the notion that poor therapy and/or poor patient adherence has an enormous impact on the health-related quality of life of South Africa's asthmatics.