Patient perceptions of living with severe asthma: Challenges to effective management

Background: The management of severe asthma poses many challenges related to treatment, adherence and psychosocial morbidity. There is little direct data from the patient perspective to understand and negotiate the complexities of managing severe asthma Objective: To explore the patient perceptions of living with severe asthma and the experience of managing severe asthma, in order to better understand the support that might promote more effective self-management for severe asthma. Methods: Participants were recruited from a specialist Difficult Asthma Service. Semi-structured interviews were conducted by researchers independent of the patient’s care. Interviews were transcribed verbatim and inductive Thematic Analysis was performed. Results: Twenty-nine participants [13 male, mean (SD) age 49.5 (13.6) years, mean Asthma Control Questionnaire 2.2 (1.2)] participated in an interview. Analysis resulted in four major themes describing the experience and challenges to managing severe asthma: Understanding of severe asthma, emotional impact of living with severe asthma (sub-theme: fear of hospitalisation), public perceptions of asthma, and concerns about medications. Conclusion: Healthcare professionals need to consider and discuss with patients their perceptions of severe asthma and the relevant treatments; particular attention should focus around education of disease control and actively exploring thoughts around hospitalisation. Our data highlights the potential for psychological and social support to enhance self-management by directly addressing the wide-ranging individual challenges patients face. There is also a need for greater public awareness and education about severe asthma to minimise patient distress particularly in the work environment.