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Need for improved asthma care across Europe

A groundbreaking survey revealing the potentially catastrophic impact of severe asthma on the lives of people across Europe has been published in the latest issue of leading scientific journal Allergy. According to the report, commissioned by The European Federation of Allergy and Airways Diseases Patients Associations (EFA), 90% of the six million people in Europe with severe asthma are not receiving optimum care, leading 1.5 million of them to live in "constant fear" that their next attack could be fatal.

The report, The Limitations of Severe Asthma: The Results of a European Survey, exposes the devastating impact of the condition on the quality of life of patients and their families. Participants in the survey were asked what it means to live with the burden of severe asthma: results reveal that the symptoms of the condition not only limit patients' lifestyles, with almost 70% unable to take part in physical activity, but mean that one in five also experience speech-limiting attacks at least once a week, leaving them unable to draw enough breath even to ask for help.

"The shocking irony of these findings is that severe asthma can be successfully managed if asthma guidelines are followed effectively. Yet, according to this study, most people with severe asthma in Europe are failing to receive adequate standards of care that reach recommended international GINA (Global Initiative for Asthma) treatment targets," comments Professor Martyn Partridge, study author and chair of respiratory medicine at the National Heart and Lung Institute. For the majority of the millions of Europeans with severe asthma, these targets should be achievable, but the report shows that as many as 90% are missing at least one of the five recommended treatment goals. Unfortunately, patients who are inadequately treated are more likely to suffer frequent attacks and are at greater risk of hospitalisation and, in some cases, death.

As might be expected, the discovery that most people with severe asthma are not receiving satisfactory levels of care was accompanied by the finding that the majority of patients are not optimistic that their national healthcare systems will provide better levels of care in the future. When asked to choose one thing they hoped their government would do to improve asthma care, almost a third of respondents stated a wish for further investment in research and 14% hoped for a ban on smoking in public places.

Recent legislative milestones are a positive sign that the European Parliament (EP) and member states are beginning to recognise the true socioeconomic impact of the condition and the need for improvements in levels and consistency of care. Publication of the report follows on the heels of the EP's vote on the EU Seventh Research Framework Programme (FP7), which makes respiratory diseases and allergies a research priority until 2013. In addition, following input from EFA and other key stakeholders, the European Commission published a Green Paper in January, which detailed the dangers of secondhand smoke and called for further consultation and debate on the best way to tackle secondhand smoke across the EU.

Despite these positive steps, the survey exposes the shortfalls that clearly persist in the management of severe asthma throughout Europe and the fact that a great deal more needs to be done to ensure consistency in the standard of care. Asthma affects 30 million people across the continent and costs healthcare services approximately €17.7b a year - a cost that could be significantly reduced if access to effective patient-centred care was a rule, not a privilege, across Europe. In Western Europe one person dies every hour as a result of severe asthma, but 90% of these deaths could be prevented with effective management of the disease.

"We must continue to increase public awareness, improve patient education and provide better access to appropriate healthcare for all people with asthma to ensure that a consistent level of care is provided for all and to prevent needless deaths. EFA's collaborative work sets out an achievable vision of control over asthma, through the delivery of excellent care, investment into research and implementation of policies that reflect the right to breathe clean air. This vision must now be backed up by positive government action across Europe," says Donna Covey, chief executive of Asthma UK.

"It is the right of every person with asthma across the continent to expect high-quality care that truly meets their needs. Asthma UK's Asthma Charter was developed exactly for this purpose and aims to help patients in the UK, as well as healthcare professionals, recognise the high-quality treatment and support that they are entitled to receive."