In a study of inner-city adults with persistent asthma, more than half believed their disease was episodic, only occurring when symptoms were present, according to a new report in the medical journal Chest.

This “no symptoms, no asthma” belief, as the authors call it, can interfere with asthma management, since it is a chronic condition that needs to be treated even when there are no flare-ups.

Dr. Ethan A. Halm, from the Mount Sinai School of Medicine in New York, and colleagues theorized that not perceiving asthma as a chronic disease and treating it accordingly may contribute to the problem of asthma among people living in inner-city areas. .

The team studied 198 adults who were hospitalized with asthma at an inner-city hospital over a 12-month period. The patients were surveyed to gauge their perceptions about their disease, medication usage, and other health issues. The study participants were largely low income and nonwhite people who often had to go to the emergency room for asthma, or be admitted to the hospital, the researchers point out.

The majority of respondents, 53 percent, believed that when they didn’t have symptoms they didn’t have asthma, the report indicates. Men and older people were most likely to have this “no symptoms, no asthma” perception.

These patients also often expected to be cured.

Patients who thought asthma was not a chronic condition were 33 percent less likely to adhere to inhaled steroid treatment when they had no symptoms, compared with other patients, the report shows.

By asking patients a single question, ‘Do you think you have asthma all of the time, or only when you are having symptoms?’, doctors can spot those who would benefit from extra help in sticking with an ongoing treatment regimen, Halm and his colleagues conclude.

SOURCE: Chest, March 2006.