Inadequate antiasthma drug use in the north of Italy.

ABSTRACT: A multicentre survey of prevalence, determinants and management of
asthma (the European Community Respiratory Health Survey (ECRHS)) has shown
that the ratio of subjects declaring current use of antiasthmatic drugs to those reporting
asthma attacks in the previous 12 months was particularly low (0.54) in the north
of Italy.
In this study, we used a standardized clinical interview to gather a more detailed
insight into the issue of asthma undertreatment in the north of Italy. A total of 1,104
subjects were interviewed, 116 of whom had been defined as asthmatic by the family
doctor. Fifty subjects had current asthma and 66 had a history of previous asthma.
A considerable percentage (26%) of subjects with current asthma were not being
treated with antiasthmatic therapy. Even when only patients with severe asthma were
considered, the percentage of untreated patients was still high (21%). Forty two per
cent of subjects used inhaled beta2-agonists alone, 28% inhaled steroids plus beta2-
agonists, 2% inhaled steroids alone and 2% other drugs. Only 19% of the asthmatics
on treatment, 85% of whom had more severe asthma, received daily treatment. Only
65% of the subjects who had received antiasthmatic drug prescriptions declared they
had taken all the drugs prescribed; this percentage was 74% when respiratory symptoms
were worsening. Of the patients with past asthma, 18% had taken antiasthmatic
drugs. Most of these patients were those who had had more severe asthma.
In conclusion, antiasthmatic drugs are underused in the north of Italy, at least in
part due to low compliance.