Background
Chronic respiratory diseases are among the leading causes of morbidity and mortality, and the prevalence of these diseases is expected to increase in the coming years. Data published by the WHO suggest that hundreds of millions of people currently suffer from these conditions worldwide. It is estimated that there are approximately 7 million asthma and COPD patients in Italy, comprising 11.5% of the general population. The prevalence of asthma is 6.2%, or a total of approximately 3.7 million patients. COPD has a prevalence of 5.3% (for a total of approximately 3.3 million cases). Every year, nearly 300,000 new cases of asthma and COPD are reported (an estimated incidence of 6%), and there are approximately 40.000 deaths yearly (6.8%) (22,329 men and 17,620 women). Italy spends 14 billion euros each year on respiratory diseases (equal to 1% of the Italian GDP); of these costs, 5 billion euros are for direct/indirect costs associated with asthma and 9 billion euros are for direct/indirect costs associated with emphysema and/or COPD. The weighted per capita cost of asthma therapy is equal to 1,434 euros, whereas it is 2,723 euros for COPD.
Although effective therapies exist for these conditions, chronic respiratory diseases are frequently not adequately treated. One of the main problems is a lack of adherence to treatment by patients.
The term 'compliance' (the extent to which a person's corresponds to physician's prescription) has been used for a long time to define the observation of the prescriptions (i.e. drugs, medical devices, dietary or behavioural prescriptions) by the patient. More recently, the term 'adherence' has been preferred over the concept of compliance because of the authoritative and paternalistic connotations of the latter one. Adherence has been defined as the extent to which a person's behaviour corresponds to the recommendations agreed with a health care provider'. Adherence involves consumer's choice and is intended to be non-judgemental, at variance with compliance, which reinforces patient passivity and blame.
The treatment of these diseases involves the administration of drugs using an inhaler device and specific techniques that the doctor must explain to the patient. During treatment, the patient may encounter a difficulty in using the device, leading to under-use and/or misuse. This improper use has inevitable consequences on both the health of the patient and the entire health care system.
Relatively little research has addressed the public awareness of asthma, COPD and related treatment issues.
The aim of the present public pragmatic survey is to evaluate the following:
opinions, beliefs and perceptions of Italian people regarding respiratory diseases.
attitudes, motivations and barriers regarding the use of inhaler devices.