Questionnaire-based Analysis of the Current Status of Adult Bronchial Asthma in Niigata Prefecture : Comparison with the Asthma Guidelines

Objective : Although inhaled steroids are strongly recommended in several guidelines for the management of bronchial asthma, the actual clinical situation requires clarification. This study presents the current status of adult bronchial asthma by questionnaire-based analysis, and suggests an improved method of assessment for asthma management compared with the guideline strategy. Methodology : Questionnaires were completed by asthmatic patients and their physicians in participating institutions within Niigata Prefecture from September to October 1998. The 3,347 responses were then analyzed. Results : The rate of peak-flow meter per user was only 30.8%. Attacks that were more than moderate were found in less than 10% of subjects, while asthma related symptoms--including coughing--were found in more than 50% of subjects. Emergent events were often existed (unconsciousness attacks; 6.8%, respirator management; 5.9%, aspirin induced attacks; 8.6%, respectively). Although inhaled steroid use reached 62.0%, sustained-release theophylline was used by 76.9% of subjects. Conclusion : Despite satisfactory results in asthma attack control, there is still room for improvement of the peak-flow meter and inhaled steroid use, as well as for alleviating asthma-related symptoms and preventing death related risk factors. Sustained-release theophylline was positioned as a fundamental medication and requires reevaluation as a long-term controller the same as inhaled steroids.