Coping with asthma : is the physician able to identify patient's behaviour?

INTRODUCTION: The strategies patients use to manage their asthma (coping) have been found to be associated with clinical and patient-reported outcomes. OBJECTIVES: The aim of this large cross-sectional survey is to assess the use of coping methods employed by patients with asthma and to explore the ability of general practitioners (GPs) to correctly identify these strategies. METHODS: A modified Coping Orientations to Problem Experienced Questionnaire was completed by patients with asthma and their physicians. RESULTS: The survey was completed by 3089 GPs (69% male; mean age 55 ± 6) and by 6264 patients (52% male; mean age 45 + 14). Active strategies were reported as the predominant method of coping by 51-59% of patients, whilst passive/avoidant techniques accounted for 12-28%. GPs believed the active coping methods were employed primarily by 35-45% of patients and the passive/avoidant methods by 8-26%. Physicians were able to identify the specific strategy used by a patient in 34%-64% of cases. The ability to identify the use of active strategies rather than the passive/avoidant was significantly higher (T test 8,250, p < 0.0001). Coefficient of concordance between GPs' and patients' answers was fair. CONCLUSIONS: These results revealed the extent of maladaptive coping strategies used by patients and the tendency for physicians to underestimate these. These observations may well represent two obstacles in improving asthma clinical outcomes.