'Out of Control' - how asthma patients' vs. doctors definitions is holding back healthcare

Patient engagement has been on the healthcare industry agenda for many years now. The theory is simple - if patients and doctors can work together, each listening and respecting each other for what they can contribute, the result is more motivated patients with better outcomes. But in practice, doctors and patients may not even be on the same page - with healthcare professionals believing the symptoms of their patients are being well-managed in a way patients themselves may not recognise, or even expect are possible to be managed.

A case in point is the recent Asthma & Allergy Networksurvey of nearly 3,000 asthma patients and over 850 healthcare providers in the US, exploring how well controlled they think asthma is. Most of the patients considered their asthma symptoms were under control, and that their lives were not severely affected by the disease. Yet, 70 percent of these same patients had frequent experiences of some sort of limitations while performing daily activities, like walking, getting sufficient sleep, or doing regular household chores. In contrast, 84 percent of the surveyed healthcare providers claimed their patients should not experience any limits in this type of activities.

The findings also highlight a communication gap between patients and healthcare providers regarding the conversations during routine appointments. Fewer than half of patients surveyed said they discussed symptoms, with barely 30 per cent saying they discussed how asthma affects daily life. Even fewer discussed an asthma action plan. However, the majority of healthcare providers report regularly discussing these same topics with their patients.

This case study illustrates how important the quality of dialogue is between patients and their physicians. By encouraging patients to describe their personal, everyday activities, doctors can frame the definition and expectation of controlled asthma in ways that patients can genuinely engage with. Daily symptom diaries could become more like real diaries - about what matters to patients, rather than a standardised checkbox assessment of severity.

As with so many aspects of healthcare, choosing and including the patient experience as a focal point for treatment and care has the opportunity to improve patient engagement and their health outcomes.