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| |  Asthma Study Reveals Patients Skip Medication To Avoid Side Effects FAIRFAX, VA -- Aug. 25, 1999 -- A study published in this month’s issue of the Journal of Allergy and Clinical Immunology indicates that more than 60 percent of asthma patients suffer from medication side effects. The study, which was conducted among the membership of the Allergy and Asthma Network-Mothers of Asthmatics, Inc. (AAN-MA), reveals that up to one-third of adults and almost one-quarter of pediatric patient caregivers reporting side effects had skipped doses or taken less medicine than prescribed in an attempt to reduce medication side effects and improve quality of life. "Physicians may be surprised to find that such a large proportion of their patients experience intolerable side effects such as shakiness and jitteriness, which cause them to forego symptom relieving medicine," explained Martha White, MD, director of research at the Institute for Asthma and Allergy at Washington Hospital Center and lead author on the article. "It's sad to think that so many people find that side effects from their bronchodilators, which are supposed to relieve asthma symptoms, cause symptoms which are sometimes more bothersome than the shortness of breath they are supposed to relieve." "We weren't surprised to find that many patients experience side effects and that a solid percentage of them are skipping doses," said Nancy Sander, president and founder of AAN-MA. "While asthma medications offer relief when used, their effects can disrupt the routine of the entire family. "Caregivers of children with asthma often complain about bronchodilator side effects that make their child hyperactive or unable to sleep at night. Adults with asthma have concerns about feeling jittery or inattentive at work or important social occasions." The 1,810-patient study also documented that the groups more likely to have emergency room visits, unscheduled doctor visits or be sent home from work or school for asthma had been classified by their physicians as having mild asthma. Asthma accounts for one in six of all pediatric emergency visits in the U.S. and an estimated 10 million lost school days annually. People over 18 years of age are estimated to lose three million work days due to asthma each year. "It is unusual for patients with mild asthma to experience these kinds of emergency episodes when asthma is well-controlled," Dr. White said. "Whether these events occurred after missed or decreased doses is unclear. However, the compliance issues brought to light by this study are a call-to- action for more comprehensive asthma education and follow-up by physicians and other medical caregivers." A clear majority of respondents -- 57 to 79 percent of pediatric patients' parents and 63 to 79 percent of adult patients, depending on dosage forms used -- experience unwanted side effects from bronchodilators, the most widely used form of anti-asthma drug. Although more than four out of five parents of users of all types of bronchodilators discussed medication side effects with their physicians, the study found that less than four percent perceived their physicians as prepared to discuss concerns, possibly because of the lack of alternatives. Parents reported that only 16 to 24 percent of physicians were willing to change the dose, frequency, or brand of bronchodilator treatment regimens with the goal of minimising side effects, although there are currently a growing variety of treatment options for asthma. "Physicians have many choices of medication to control asthma but unfortunately not many of the choices eliminate side effects," Dr. White said. "Oftentimes the benefit of the medication outweighs the risk and we have to ask patients to tolerate the side effects. Fortunately, new medications are being introduced every year -- some with the ability to reduce side effects without compromising efficacy -- like levalbuterol, a new bronchodilator labelled for nebulizer use in patients 12 years of age and older." According to Dr. White, patients who are experiencing side effects should always discuss them directly with their doctor before making any changes to their treatment. Physicians can sometimes relieve side effects with a new medication or a different dosage. "Some doctors just aren't aware that patients find the side effects so intolerable," Sander said. "Approaching your doctor with your concerns is a step toward breathing easier, but you can also take some steps on your own."
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