Misunderstanding and misuse: Canadian asthmatics' patterns of use and knowledge of Inhaled Steroids (IS)

Introduction: The purpose of the study was to examine: i) how and when asthma sufferers were using IS; and ii) what they understood about the effects of IS. Method: Telephone interviews were conducted with 829 Canadian asthma sufferers (AS) age ≥16 between Nov. 30, and Dec. 30, 1995. Sample was generated using random digit dialing, stratified by province. Results: Asthmatics taking an IS (n=334) were asked whether they used it: "When you get an attack or have difficulty breathing?" (prn); "Before you exercise or do something which you think might cause an attack?" and "Every day on a regular basis, to help control your asthma?" Those not using IS every day were asked: "Do you take this medication every day to help control your asthma during certain times of the year...?" A total of 77% take their medications on a regular basis, either daily or seasonal. 57% take IS prn, to treat attacks, and 30% take them prior to events likely to cause an attack. Many of those who take IS regularly also take them pm (46%) and/or to prevent a specific attack (35%). Those taking IS on a regular basis (n=257) were asked: "Which of the following best describes what you know about what [IS] does for you? i) helps control my asthma by reducing inflammation in my airways; ii) helps control my symptoms by opening up my bronchial tubes; iii) helps me, but I am not really sure how it works or what it does." 40% felt IS reduced inflammation, 38% thought IS relieved bronchoconstriction and 23% admitted they did not know. Those aware IS reduced inflammation were less likely to use IS prn (34% vs 54% p.002), but no more likely to use IS to prevent attacks (34% vs 35%). p.93 Conclusion: A total of 62% of asthmatics are misusing IS by taking them prn to relieve attacks, or to prevent specific attacks. This misuse provides little benefit and may give a false sense of security. Educating patients about the anti-inflammatory effect of IS should result in more appropriate usage.