OBSERVATIONAL VIGNETTE STUDY TO EXAMINE PATIENT, HEALTHCARE PROVIDER, AND CAREGIVER PERCEIVED BURDEN OF ASTHMA-RELATED EXACERBATIONS

Introduction Little is known about how patients, caregivers and healthcare providers (HCPs) perceive the impact of asthma-related exacerbations. This study examined the burden of asthma-related exacerbations on patients’ lives from these different perspectives. Methods Web-based surveys were administered to a US sample of adult asthma patients, caregivers, and HCPs. Participants reviewed six vignettes describing two hypothetical asthma patients (25-year-old, single, unemployed; or 45-year-old, married, employed) experiencing mild, moderate, or severe exacerbations and rated the impact on eight measures: EuroQOL-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), sleep, household costs, and medical costs. The proportions reporting “problems”, “impact”, or “burden” for each measure were calculated for each vignette; and patient responses were compared to caregiver and HCP responses. Results 302 asthma patients, 300 caregivers, and 300 HCPs completed the survey.  Table 1 shows characteristics of these groups. No differences were detected in the proportions of perceived problems/impact/burden between patients and caregivers. Compared to HCPs, a greater proportion of patients reported problems with pain/discomfort related to mild and moderate exacerbations. HCPs were more likely to indicate sleep impact, mobility problems, and financial burden across all exacerbation severity levels; self-care problems with moderate and severe exacerbations; and problems with usual activities and anxiety/depression for severe exacerbations, as compared to patients. Conclusions Patients and caregivers share similar views on the impact of asthma exacerbations, yet HCPs may be less aware of patients' concerns about pain and discomfort related to exacerbations. Recognizing distinctions in perceptions may be an important consideration for optimizing patient care.