Willingness of patients to perform self-management of asthma and the role of inhaled steroids

Objective - Asthma self-management is a generally accepted effective treatment strategy for asthma patients. Acceptance by patients may be a barrier for successful implementation. In this study, the role of inhaled steroids in starting asthma self-management is described. Design - Cross-sectional explorative study. Setting - General practice. Subjects - 283 adult steroid-requiring asthma patients were invited by their GP to participate in a self-management programme. Main outcome measures - In a multivariate logistic regression model, the relation between baseline dosage of inhaled steroids, occupational status, age and sex as independent variables and willingness to participate as dependent variables was explored. Results - Of all invited, 148 (52%) were willing to participate. Subjects not using inhaled steroids were least willing to participate (43/143 = 30%). Subjects with low doses of inhaled steroids (< 400 meg daily) were most willing to participate (44/54=81%). Unemployed asthmatics had a higher tendency to participate than patients with a regular job. Conclusion - Acceptance of self-management by patients is not a limiting issue in promoting self-management of asthma in general practice. High acceptance in patients taking low or intermediate doses of inhaled steroids makes general practice the most appropriate setting for self-management. A selection procedure is recommended.