Patient experience, understanding and self-management of asthma attacks: a qualitative study

Asthma attacks (AA) are potentially life-threatening complications of asthma associated with high levels of morbidity, mortality and rising healthcare costs. Patient experience, impact and understanding of AA is poorly described in the literature. Enhanced understanding will identify unmet needs in asthma care and support the development of improved personalised strategies for managing and preventing attacks. To explore patients’ experiences and understanding of AAs, the impact of AAs on their lives and self-management strategies during attacks. Single centre (UK) qualitative semi-structured interview study with 30 patients who recently had asthma attacks (≤4 weeks). Data were analysed using the framework approach. The patient experience and impact of AA varied, including recognising an impending attack. Variation in patients’ self-management behaviours during AAs was observed and was influenced by prior experience of attacks and care received for these and other life priorities. Several behaviours previously recognised as contributory to asthma deaths, including short-acting β-agonist (SABA) overuse, poor recognition of the risk of adverse outcomes, and delay in seeking medical help, were identified and reported. Most patients had a poor understanding of AAs and their management. This study describes the differing impact of AA on patient experiences and understanding of asthma attacks. These differences, combined with healthcare factors and attack characteristics, affect patient self-management approaches. These findings highlight unmet needs in asthma attack care. ClinicalTrials.gov ID NCT04410120 Academic Clinical Lecturer Starter Grant provided by Health Education England