Answering Three Simple Questions Could Improve Asthma Control for Millions of Patients and Save Lives

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New survey shows troubling disconnect between perception and reality of asthma control.

If you have allergic asthma, new survey findings confirm expert opinion that answering three simple questions -- do you sleep tight? Do you work right? Do you play with might? -- could help improve asthma control for millions of patients and save lives. A new Harris poll shows that 88% of asthma sufferers believe their disease is under control, yet asthma still accounts for nearly 2 million emergency visits each year (i).

A Special Report in the April issue of Annals of Allergy, Asthma, & Immunology, "Improving Asthma Control: Talk Is Not Cheap (ii)," finds that poor asthma control is much more prevalent than it should be and a key problem is ineffective communication between patients and their health care providers (HCPs). The report authored by Paul Ehrlich, M.D, a member of Asthma and Allergy Foundation of America's (AAFA) Better Control for Better Living (BCBL) panel addresses these issues and introduces a new framework for improving asthma control through communication. The Sleep Work Play™ program ( is intended to help patients recognize and better communicate their symptoms and lifestyle changes with the goal of achieving greater asthma control and an improved quality of life.

"One of the key factors contributing to this country’s rising asthma epidemic is that patients are not equipped to recognize and manage their triggers and symptoms. As a result, patients don't effectively communicate with their doctors and end up comprising basic daily activities," said Paul Ehrlich, M.D., Clinical Assistant Professor and Allergist, New York University School of Medicine, attending at Beth Israel Medical Center in New York City, and lead author of the Annals Report. "Sleep/Work/Play is a practical and simple communications framework for doctor-patient-parent discussions about the impact of allergic asthma on quality of life, and the importance of control in managing these conditions."

Creative Solution: SLEEP/WORK/PLAY

The Annals of Allergy, Asthma, & Immunology Special Report reveals that HCPs and patients have different understandings of asthma control and use different words to talk about that control. The Report recommends asking specific, activity-related questions; for example "Has your asthma caused you to wake up in the middle of the night? How often? How recently?" Questions such as these can help HCPs gain a more complete picture of the patient's level of asthma control.

Sleep/Work/Play (supplemented with Sleep/Learn/Play™ for adolescents) provides a common language and practical tools for HCPs, patients and parents to use in discussions about asthma and allergic asthma control. The program encourages a more specific, probing discussion between patients and HCPs that relates to these three essential components of everyday life:

•    Do you sleep tight? Sleep questions include whether asthma symptoms caused a patient to awaken, cough or be overly tired the next day.

•    Do you work right? Learn/work questions include whether asthma resulted in missed days, leaving early, interruption (e.g., for rescue inhaler) or change of job.

•    Do you play with might? Play/activity questions include whether asthma interfered with or resulted in avoidance or adjustment of play, exercise or a social activity.

This enhanced dialogue will help HCPs and patients determine their level of asthma severity and make proper treatment decisions. Please visit and for more information and program materials.

Survey Findings Support SLEEP/WORK/PLAY Program

Findings from the recent Harris survey conducted on behalf of AAFA further underscore the need for the Sleep/Work/Play program. Key results show that the majority of asthma patients and caregivers incorrectly believe that their asthma symptoms are under control. Furthermore, conversations about severity of symptoms and treatment do not appear to be taking place between many sufferers and their HCPs. For example, less than one in two sufferers' HCPs (47%) and (66%) of caregivers’ HCPs have initiated conversations about when asthma is severe enough to call a doctor or go to an emergency room.

Most Asthma Patients Over-Estimate Level of Control: a majority of asthma patients believe that their asthma is under control (88%), despite the fact that:

• 61% have had to catch their breath while running upstairs

• 50% have had to stop exercising midway through their regimen

• 48% have been woken up in the middle of the night as a result of their asthma

Parents Over-Estimate Child's Level of Control: a majority of asthma caregivers believe that their child's asthma is under control (89%), despite the fact that:

•    49% of their children have had to miss days of school and/or work

•    49% of their children have had to stop exercising midway through their regimen

•    45% of their children have been woken up in the middle of the night as a result of their asthma

More Than Half of Asthma Patients Say Their HCPs Have Never Talked About Attack Procedures

•    Less than one in two sufferers' HCPs (47%) have initiated conversations about when asthma is severe enough to call a doctor or go to an emergency room. This number is a little higher for the caregivers (66%)

For the full survey results, visit

Harris Interactive® fielded the ten question survey, via its QuickQuerySM online omnibus, on behalf of the Asthma and Allergy Foundation of America (AAFA). This online study was conducted among a nationwide sample of 4,598 U.S. adults 18 years of age or older. The data were weighted to be representative of the total U.S. adult population on the basis of region, age within gender, education, household income, race/ethnicity and propensity to be online. Interviewing for this omnibus survey was completed between March 2 and March 4, 2005. The sampling error for the total sample is plus or minus 1.5 percentage points.

About Asthma and Allergic Asthma

Of the 20 million Americans living with asthma, the latest research shows that more than 50 percent suffer from allergic asthma (iii), making it the most common form of the disease. Asthma is the country's most common and costly illness (iv), accounting for nearly half a million hospitalizations and two million emergency room visits, and more than 10 million physician office visits annually (v).

In addition, nearly four out of five Americans (77 percent) are directly affected by asthma; half (48 percent) have asthma in their household or immediate family, and another 29 percent know someone with the disease (vi).    

Allergic asthma is triggered by exposure to allergens like pollen, dust mites and mold. Aside from knowing the triggers, it is important that allergic asthma sufferers understand the role of an antibody called immunoglobulin E, or IgE, which is a key component of the allergic cascade that triggers asthma symptoms. Current asthma therapies generally treat the symptoms of asthma, not the underlying cause of the disease. However, recent advances in understanding the role of IgE have led to novel approaches in asthma management.

About AAFA

The Asthma and Allergy Foundation of America (AAFA) is the leading nonprofit consumer and patient organization fighting asthma and allergic diseases. AAFA provides free information to the public, offers educational programs to consumers and health professionals, leads advocacy efforts to improve patient care and supports research to find cures.

Better Control for Better Living™, Sleep Work Play™ and Sleep Learn Play™ are part of AAFA's educational initiative, which is made possible by an unrestricted educational grant from Genentech, Inc. and Novartis Pharmaceuticals Corporation.

About Harris Interactive®

Harris Interactive® Inc. (, the 15th largest and fastest-growing market research firm in the world, is a Rochester, N.Y.-based global research company that blends premier strategic consulting with innovative and efficient methods of investigation, analysis and application. Known for The Harris Poll® and for pioneering Internet-based research methods, Harris Interactive conducts proprietary and public research to help its clients achieve clear, material and enduring results.

Harris Interactive combines its intellectual capital, databases and technology to advance market leadership through U.S. offices and wholly owned subsidiaries: London-based HI Europe (, Paris-based Novatris (, Tokyo-based Harris Interactive Japan, through newly acquired WirthlinWorldwide (, a Reston, Virginia-based research and consultancy firm ranked 25th largest in the world, and through an independent global network of affiliate market research companies.


(i) National Center for Health Statistics. Monitoring Health Care in America. Spotlight on lung disease. Quarterly Fact Sheet. December 1996

(ii) Ehrlich, P. Improving control: talk is not cheap. Annals of Allergy, Asthma & Immunology 2005 April; 94 : 415-418

(iii) National Institute of Environmental Health Sciences, Fact Sheet #9 "ASTHMA and its Environmental Triggers: Scientists Take A Practical New Look at a Familiar Illness." July 1997

(iv) Asthma and Allergy Foundation of America: Asthma Facts and Figures. Asthma and Allergy Foundation of America (AAFA). December 7, 2004

(v) National Center for Health Statistics. Monitoring Health Care in America. Spotlight on lung disease. Quarterly Fact Sheet. December 1996

(vi) Asthma in America Survey. Select national/regional survey data. Accessed November 24, 2004

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Mike Tringale M.S.M., Director of Marketing and Communications

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