TSANZ Poster Presentations

Introduction/Aim: Severe asthma exacerbations are common and have major impacts on outcomes.The 2017 Lancet Asthma Commission 1 called for zero-tolerance on exacerbations and has recommended replacing 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.Methods: Semi-structured qualitative interviews were conducted with 14 adults with severe asthma.Interviews explored individuals' experiences 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 analysis.Results: Participants had a meanAESD age of 59AE12 years and 57% were female.MeanAESD FEV 1 % predicted and ACQ6 were 61AE25% and1.8AE1.2units, 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 'exacerbation' was perceived as being used by health professionals to 'medicalise' 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. Conclusion:Exacerbation and flare-up have a different meaning to patients with severe asthma than how they are intended.These data provide important person-centred support to the recommendations of the Lancet commission 1 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.