Unmet needs of older people with asthma: cross-sectional survey.

Introduction: Asthma in older people is a major cause of disease burden in Australia and is projected to increase over the next two decades. Current guidelines for asthma care rely predominantly on studies from younger populations.

Methods: We undertook a cross-sectional survey of older people with asthma to identify their concerns and their perceived asthma symptom burden. One hundred and ninety-nine people over 55 years of age with asthma were recruited from community pharmacies, in the states of Victoria and NSW, Australia.

Results: One-hundred and twenty (62%) participants reported "perfectly" or "very well controlled" asthma over the past month, and 78% claimed adherence to asthma treatment. Despite this, 105 (55%) reported experiencing moderate to severe symptoms and 58 (30%) moderate to extreme restrictions on their lifestyle in the past month. Exacerbations were also common with over one-third of participants seeking emergency asthma care or requiring oral corticosteroids in the past 12 months. In spite of 80% of participants reporting confidence of how to manage their asthma properly, only 10% said they would call an ambulance or visit an Emergency Department if their asthma was "out of control." Further asthma self-management education was considered desirable by two-thirds. However, those over 65 years preferred less autonomy in decision-making compared to those under 65 years. CONCLUSION. Older people with asthma experience a high symptom burden. A simplified version of our questionnaire could assist GPs, specialists, and asthma educators to identify the individual needs of older patients and to tailor their delivery of asthma care accordingly.