RESUMO
BACKGROUND: Engagement with exercise in adults with asthma is suboptimal. Limited information is available regarding factors affecting engagement with exercise. AIM: To explore experiences of exercise and linked unmet needs in adults with asthma. DESIGN & SETTING: Qualitative thematic analysis of posts in a UK asthma online community, written between 2015 and 2020. METHOD: Posts were identified using keywords searches. Posts in the 'Exercise' topic section were additionally included. Thematic analysis of posts was undertaken. RESULTS: A total of 143 relevant posts were analysed. Ninety-two participants were identified through posts (11 male, 33 female, 48 sex not stated, aged 26-73 years). Emerging themes included the following: fear of experiencing asthma symptoms during exercise; lack of information about how to deal with symptoms; external barriers; emotional response; and involvement of healthcare providers. Environmental factors, concomitant life stressors, distrust of healthcare professionals, and embarrassment about displaying asthma symptoms during exercise were barriers to engagement. Facilitators included experiencing positive health outcomes following exercise and positive discussions regarding exercise with healthcare professionals. Strategies participants developed to enable exercise were warming up, increasing reliever and preventer inhalers when exercising, and finding exercises the individual felt were enjoyable. CONCLUSION: Future interventions to address fears of exercise-induced physical symptoms, and clear instructions on the use of inhalers when exercising are needed. Exploring patients' attitudes to exercise in clinical consultations, especially in primary care, may be beneficial.
RESUMO
BACKGROUND: Inhaler shortages were reported in the UK following declaration of the COVID-19 pandemic, prompting advice against stockpiling. AIM: To understand experiences and behaviours of patients with asthma requesting prescriptions from primary care during asthma medication shortages. DESIGN & SETTING: UK asthma online community, between March and December 2020. METHOD: Thematic analysis of posts identified using search terms 'shortage', 'out of stock', 'prescribe', and 'prescription'. RESULTS: Sixty-seven participants were identified (48 adults, two children, 17 unstated age). Factors leading to increased requests included the following: stockpiling; early ordering; realising inhalers were out of date; and doctors prescribing multiple medication items. Patients' anxieties that could lead to stockpiling included the following: fear of asthma attacks leading to admission and acquiring COVID-19 in hospital; lack of dose counters on some inhalers; and believing a lower amount of drug is delivered in the last actuations. Strategies adopted in relation to shortages or changes in treatment owing to out-of-stock medications included the following: starting stockpiling; ordering prescriptions early; contacting medical professionals for advice or alternative prescriptions; getting 'emergency prescriptions'; ordering online or privately; seeking medications in different pharmacies; contacting drug manufacturers; and keeping track of number of doses left in canisters. No evidence was found of anxiety-triggered asthma symptoms that required medications due to fear of COVID-19. Participants seemed to disregard advice against stockpiling. CONCLUSION: Better preparation is a key lesson from the COVID-19 pandemic. Clinicians, the pharmaceutical industry, and policymakers should use insights from this work to plan how to better manage medication shortages in future emergency situations.