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The survey reveals that the treatment of asthma is falling far short of asthma guidelines established by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health:
- The NHLBI guidelines say that one of the goals of asthma management is no or minimal need for emergency room visits or hospitalization. The survey shows that nearly one in ten persons with asthma (9%) were hospitalized overnight for asthma in the past year; almost one in four (23%) had to go to the emergency room for asthma last year, including a third (32%) of all children with asthma; and nearly three out of ten (29%) asthma patients had other unscheduled asthma-related emergency visits to a doctor's office, clinic or somewhere else. (Figures 3,4,5)
- In contrast to the NHLBI goals for asthma management, more than four out of ten persons with asthma (41%), and a majority of children with asthma (54%), were hospitalized, treated in emergency rooms, or required other urgent care for their asthma in the past year. (Figure 6)
- Another goal of asthma management is no missed school or work due to asthma. The survey finds that one in two children (49%) and one in four adults (25%) missed school or work in the past 12 months because of their asthma. (Figure 7)
- No sleep disruption is another goal for asthma management. The survey reveals that one in three patients (30%) is awakened with breathing problems at least once a week. (Figure 8)
- The NHLBI guidelines say that people with asthma should be able to maintain their normal activity levels. According to the survey, almost half of persons with asthma (48%) say their asthma limits their ability to take part in sports or recreation; more than a third (36%) say it limits their normal physical exertion; many say it limits them in their lifestyle (31%) or social activities (25%). (Figure 9)
One serious problem contributing to the poor level of asthma control is that a significant number of people with asthma tend to underestimate the severity of their condition and overestimate how well their asthma is being controlled:
- About one in five people with asthma (19%) report symptoms that could be classified as severe persistent asthma, according to NHLBI guidelines. Another one in five (22%) report symptoms that could be classified as moderate persistent asthma. (Figure 10) This translates into nearly six million Americans with moderate or severe persistent asthma symptoms.
- Only 22% of persons whose symptoms are consistent with severe persistent asthma (according to NHLBI guidelines) actually describe their asthma symptoms as severe. Only 41% of those who reported symptoms consistent with moderate persistent asthma describe their asthma as moderate or severe. (Figure 11) Hence, the majority of persons with moderate or severe asthma symptoms appear to significantly underestimate the severity of their asthma.
- Those with moderate and severe persistent asthma symptoms also overestimate how well-controlled their asthma is. Three out of five (61%) people with moderate persistent asthma and almost one in three (32%) with severe persistent asthma consider their asthma to be "well controlled" or "completely controlled." (Figure 12)
- Based upon the symptoms and morbidity reported by the national sample of persons with asthma, it is no exaggeration to say that asthma in America is out of control.
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