Perception of the role and potential side effects of inhaled corticosteroids among asthmatic patients

BACKGROUND: Misunderstanding of the role of asthma medication and fear of untoward side effects may reduce compliance to therapy, potentially resulting in poor asthma control and increased risk of severe asthma events. METHODS: We report the results of a recent Canadian survey of 603 asthmatic patients recruited from the general population, aimed at determining their perception of the role and potential side effects of inhaled corticosteroids (ICS). RESULTS: The survey revealed that a large proportion of asthmatic patients do not understand the role of their medications and have many misconceptions and fears in regard to ICS, reducing their willingness to use them. Among the most common fears are those concerning troublesome side effects, particularly in regard to corporeal image, bone density, and a reduction in efficacy of medication over time. More than half of the population said they were very or somewhat concerned using ICS on a regular basis; two thirds of patients had not discussed their concerns about ICS with their physicians or other health-care professionals. Finally, in a large number of asthma patients, asthma was not adequately controlled, according to recent asthma consensus guidelines. CONCLUSIONS: These observations stress the importance for those involved in asthma care of questioning patients about their understanding of the role of asthma medications, particularly ICS, their fears and misconceptions, and what they consider to be adequate asthma control, in order to provide appropriate education and counseling.