Mild asthma-What matters to patients and parents.

Background: Mild asthma has received less attention despite accounting for most of patient with asthma. However, asthma complications including hospitalizations and progressive loss of lung function frequently occur in such patients. The priorities of patients with mild asthma are unknown, hindering the ability to advance care.

Objective: To identify patient and parent perspectives on the definition of mild asthma, treatment preferences, concerns and goals of care.

Methods: Participants with self-defined mild/intermittent asthma were recruited using emails distributed through the Allergy & Asthma Network and Allergy Foundation of America. A demographic survey and measures of asthma control/quality of life were completed. Focus groups consisting of approximately 5 participants and a focus group leader were conducted.

Results: A total of 20 patients and 20 parents of children with mild asthma participated. Focus groups revealed significant variability in the definition and treatment preferences. Frequency of symptoms appears to be a key driver in treatment decisions for mild asthma, and those with infrequent symptoms were opposed to the addition of an inhaled corticosteroid to albuterol. Use of recommended asthma monitoring strategies such as asthma action plans or peak flow meters was low among adults. Participants desired more education from their providers regarding asthma remission and long-term complications associated with mild asthma.

Conclusion: There is significant heterogeneity in the definition and treatment preferences among patients and parents of those with mild asthma. Shared decision making between patients and providers is necessary to personalize medical decisions in those with mild asthma.