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Delay in Seeking Medical Care Causes Many Asthma Deaths

Despite advances in the treatment of asthma, the number of patients who die from asthma-related illness continues to rise. It is estimated that more than 4,000 people in the United States die from asthma each year. This was one of the issues addressed at the 96th International Conference of the American Thoracic Society in Toronto as researchers and health care professionals gathered to discuss some of the reasons for this phenomenon.

Andrew Harver, PhD, from the University of North Carolina in Charlotte, North Carolina believes that many patients delay seeking medical care until it's too late, and he discussed some of the reasons this occurs.

Individuals with asthma frequently judge the severity of their asthma based on how they feel -- patients who don't feel short of breath often think their asthma is under control when in fact it may not be. Some patients seem to be more aware of their symptoms than others with similar levels of airway obstruction. Dr. Harver referred to one study where 15 percent of patients lacked awareness of their symptoms even when their breathing ability was reduced by more than 50 percent.

While many researchers feel that the inability to recognize symptoms is a significant problem, there is still no standard way to measure symptom under-recognition. And it is still largely unknown whether it actually results in patients delaying medical care and if so, to what extent.

Dr. Harver explained that symptom under-recognition is a common theme in asthma research, but he warned: "We have to be cautious to assume that a reduction in perceived severity was a contributing factor in delaying seeking treatment".

Nevertheless, delays in seeking medical care during an asthma attack appear to be common. Dr. Harver noted that studies estimate that patients wait anywhere from 24 hours to as long as seven days before getting help. Other reasons patients put off getting treatment include uncertainty, disruption of family life or other activities, minimization of symptom severity and fear of steroids.

Dr. Harver concluded by saying that he believes two things increase a patient's risk for having an asthma attack that results in death: poor symptom awareness and an inappropriate response to those symptoms.