Patients with severe asthma experience significant improvements in quality-of-life and participation in life with add-on monoclonal antibody therapies but there’s still more to be done.
Semi-structured interviews with 20 Australian patients revealed four emergent themes – that life is just easier, prednisone – a necessary evil, worry and hope for the future, and holistic care.
The qualitative study revealed a range of positive responses to the new treatment including a stabilisation of asthma symptoms, improved quality of life especially better sleep and more energy when awake, and less healthcare and medications use.
“I can mow the lawn without stopping, or just stopping one or two times. If I can take the rubbish out, if I can prune a tree, if I can wash the car, help the wife shopping, if I can do those without the major discomfort that I used to have, whilst there is still discomfort, it is nowhere near as uncomfortable as it used to be, if I can put it that way.” Clyde, male, 57.
However patients were still frustrated about being “stuck on prednisone”, very much concerned about the side effects, but forced to accept oral corticosteroids as a “safety net” or “last resort”.
The study, published in the Journal of Asthma and Allergy, found some patients were worried about the durability of benefit from the biologics and their future should the drugs stop working.
Other patients were more optimistic that new discoveries would come along and grateful for what they currently had.
“When I started to get it years ago, there was no medication. I was told that was all in my mind and I was just stressing too much even though I was crawling up the back steps. The fact that you have medication, I bow to the medical world.” Helen, female, 76.
Patients also recognised that the biologics alone were not enough – that they needed “the right cocktail” of medications including their puffers, and “staying healthy” through diet, exercise and medication adherence.
The investigators, from the University of Newcastle, said their study provided information that could not be gained from efficacy trials.
“Understanding these experiences will aid communication of the potential benefits and limitations of these add-on medications,” they concluded.
“Discussion points between clinicians and patients can include, what a patient can expect from their new treatment based on real-world experiences, whether the treatment will be able to reduce their oral corticosteroids, and the place of these therapies in the asthma management strategy.”