TSANZ POSTER PRESENTATIONS
Asthma & Allergy 1
PATIENT PERSPECTIVES ON SEVERE ASTHMA EPISODES:
ATTACKS, FLARE-UPS OR EXACERBATIONS?
, YORKE J
, NIVEN R
, SMITH A
, GIBSON P
Centre of Excellence in Severe Asthma and Priority Research Centre for
Healthy Lungs, University of Newcastle, Newcastle, Australia,
Department of Respiratory and Sleep Medicine, John Hunter Hospital,
New Lambton Heights, Australia,
School of Health Sciences, Faculty of
Biology, Medicine and Health, University of Manchester, Manchester,
Manchester Academic Health Sciences Centre, University of
Manchester, Manchester, UK, and
MAHSC; University of Manchester
and Manchester Foundation Trust, Manchester, UK
Severe asthma exacerbations are common and
have major impacts on outcomes. The 2017 Lancet Asthma Commission
called for zero-tolerance on exacerbations and has recommended repla-
cing the terms ‘exacerbation’ or ‘ﬂare-up’ with ‘attack’. The aim of this
study was to explore patients’ perspectives on episodes of severe asthma
and the terminology used.
Semi-structured qualitative interviews were conducted with
14 adults with severe asthma. Interviews explored individuals’ experi-
ences with severe asthma episodes and their perspective on language
used. Sampling was purposive and interviews continued until no new
themes emerged. Data were analysed using a modiﬁed thematic
Participants had a meanÆSD age of 59Æ12 years and 57%
were female. MeanÆSD FEV
% predicted and ACQ6 were 61Æ25%
and1.8Æ1.2 units, respectively. Most (71%) lived with family. Participants
described attacks of asthma as frightening events that had major impacts
on the their lives: ‘it’s an attack on your life’. The use of the term ‘exacer-
bation’ was perceived as being used by health professionals to ‘medica-
lise’ their asthma. Patients considered exacerbations and ﬂare-ups as a
transient, often common increase in their symptoms that might last hours
or days but generally led to a return to baseline. These were viewed as
being less severe events. The term ‘attack’ however had a different
meaning. Participants used this to describe serious life-threatening
events: ‘It’s an attack when it’s completely out of control’. The use of the
term exacerbation by health professionals was described as ‘insulting’ as
it trivialised their experience.
Exacerbation and ﬂare-up have a different meaning to
patients with severe asthma than how they are intended. These data pro-
vide important person-centred support to the recommendations of the
in regard to the use of the term attack. The term
attack better reﬂects the severity of events from the patient perspective.
1. Pavord ID. Lancet 2017, Sept 11.
The study was supported by the Centre of Excel-
lence in Severe Asthma and the John Hunter Charitable Trust.
Declaration of Interest Statement:
Nothing to declare
ASTHMA SELF-MANAGEMENT FOR AUSTRALIAN CHILDREN
AND THE ROLE OF APPS?
, MOLLOY C
, WILES L
, FOSTER J
, JAFFE A
Center for Population Health Research, University of South Australia,
Australian Institute of Health Innovation, Macquarie
University, Macquarie University, Australia,
Group, Woolcock Institute of Medical Research, The University of
Sydney, Glebe, Australia, and
School of Women’s and Children’s
Health, University of New South Wales, Randwick, Australia
Smartphone apps can deliver self-management
programmes for children with asthma, however the literature reports het-
erogeneous outcomes. Consumers’ perspectives are yet to be investi-
gated despite being crucial for uptake and effectiveness. This project
aimed to: 1. explore the self-management strategies and needs of chil-
dren with asthma and their carers; and 2. understand the content, design
features and usability of existing asthma apps.
Children with asthma aged 6-11 years and their carers par-
ticipated in focus groups which incorporated a group discussion followed
by user-testing of 7 asthma apps. Focus groups were recorded, tran-
scribed and analysed thematically.
Participants (children: n=41, carers: n=38) took part in one
of 31 focus groups. Carers reported being heavily involved in selfmanage-
ment activities including symptom and medication management and com-
munication with health professionals. Carers wanted children to take on
more self-management responsibility but expressed concern about relin-
quishing control. Carers and children both expressed frustration over
asthma negatively impacting social factors including a strong desire to not
be seen as different. Most carers felt positive about the potential of an
app to build awareness of their child’s experience of asthma and to
improve their child’s asthma self-management. App features found partic-
ularly useful by participants included customisation, recording and track-
ing information (e.g. symptom monitoring), education, reminders (e.g.
medication), icons and visuals and information sharing with health profes-
sionals. Missing, desired features included multiple personnel entry
options, automation, intuitive design for young children to navigate, parent
and child portals, information sharing between child and carer, and social
networking. No single asthma app tested met all needs identiﬁed as
important by participants.
These ﬁndings have signiﬁcant implications for the
future design and implementation of acceptable and effective asthma self-
management apps, and indicate the need for greater end-user involve-
ment in app design.
This study was supported by NHMRC Partnership
Editorial material and organization © 2018 Asian Paciﬁc Society of Respirology.
Copyright of individual abstracts remains with the authors.
Respirology (2018) 23 (Suppl. 1), 104–215