No symptoms, no asthma: the acute episodic disease belief is associated with poor self-management among inner-city adults with persistent asthma

Chest
Ethan A HalmHoward Leventhal

Abstract

Asthma morbidity and mortality is highest among inner-city populations. Suboptimal beliefs about the chronicity of asthma may perpetuate poor asthma control among inner-city asthmatics. This study sought to characterize beliefs about the chronicity of disease and its correlates in a cohort of inner-city adults with persistent asthma. Prospective, longitudinal, observational cohort study. One hundred ninety-eight adults hospitalized with asthma over a 12-month period at an inner-city teaching hospital. Sociodemographics, clinical history, disease beliefs, and self-management behaviors were collected by interview. Information on self-reported use of inhaled corticosteroids (ICS), peak flowmeters, and regular asthma visits was collected during hospitalization, and 1 month and 6 months after discharge. This cohort was predominantly low income and nonwhite, with high rates of prior intubation, oral steroid use, and emergency department visits and hospitalizations. Overall, 53% of patients believed they only had asthma when they were having symptoms, what we call the no symptoms, no asthma belief. Men patients, those > or = 65 years old, and those with no usual place of care had greater odds of having the no symptoms, no asthma belie...Continue Reading

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