More than half of asthma patients surveyed report that their disease is uncontrolled and that they have never received an asthma action plan, according to a report in the June Journal of Allergy and Clinical Immunology.

"[We] need better physician and patient education, to focus on asthma control at each asthma clinic visit (new emphasis from new draft U.S. asthma guidelines), and to partner with patients," Dr. Stephen P. Peters from Wake Forest University School of Medicine, Winston-Salem, North Carolina told Reuters Health.

Dr. Peters and associates in the Real-World Evaluation of Asthma Control and Treatment (REACT) assessed the prevalence of uncontrolled asthma in the United States in a nationally representative sample of patients with moderate-to-severe asthma receiving standard asthma medications.

More than half the 1812 respondents (55%) had uncontrolled asthma, the authors report.

Only 34.9% of patients with uncontrolled asthma and 26.4% of patients with controlled asthma had ever received a personalized asthma action plan from a physician for asthma management, the results indicate.

About half the patients with uncontrolled asthma and 60% of patients with controlled asthma were taking an inhaled corticosteroid and long-acting beta-agonist, the researchers note. More than half the patients with uncontrolled asthma and nearly 30% of patients with controlled asthma reported taking their asthma medications more often than prescribed.

Younger age, Hispanic race, male sex, lower income, and lower education level were independently associated with increased risk of uncontrolled disease in a multivariable analysis, as were chronic sinusitis, high blood pressure, and gastroesophageal reflux disease (GERD).

"The REACT study shows that even with access to health care, patients prescribed therapy that is recommended for moderate-to-severe asthma still demonstrate high rates of uncontrolled asthma," the authors conclude. "Our survey results highlight the critical need for improved asthma care, including a more global evaluation of asthma control, implementation of asthma treatment plans, and addressing comorbid conditions as interventions to improve asthma control in patients with moderate-to-severe asthma."

"We are now exploring attitudes associated with poor asthma control and trying to develop a ‘REACT asthma attitude score,’" Dr. Peters said.