Narrative exploration of uncontrolled asthma: insights from patients and healthcare professionals in a cross-sectional study

Background: Despite effective inhalation therapy, uncontrolled asthma remains prevalent. Narrative Medicine (NM) seeks to understand illness experiences linguistically, providing a framework to enhance healthcare. Aims: To gather narratives from uncontrolled asthma patients and Health Care Professionals (HCPs), exploring treatment decisions, adherence factors, emotions, economic burdens, and comprehensive care. Methods: A cross-sectional NM study was conducted in Italy (February-December 2023), involving 135 uncontrolled asthma patients [54.7% male; mean age:56.7 years] and 47 HCPs [64.9% male; mean age: 54.3 years]. A mixed-method approach was adopted to examine themes, language, emotions, and narrative classifications. Results: The patients reported an average illness duration of 4.46 years, with worsening occurring over the last 20.9 months. Pulmonologists (83% of HCPs) took a primary role in diagnosing and treating the disease in 96.1% of patients. Additionally, 51 patients reported incurring extra costs in the treatment of their asthma. The most frequent reported feelings were tiredness (25.96%) and feeling suffocated (11.53%). Once they started treatment, although feeling better physically, they mostly experience emotion of "submission/dependence" on the drug (28%), followed by "fear" (21%) and "serenity/joy" (21%). The HCPs, mainly pulmonologists (83%), emphasized the need for increased specialist and general practitioner awareness, including information dissemination, attention to prescriptions, phenotyping, targeted therapy, and paediatric considerations. Conclusions: The findings enhance patient understanding, personalize interventions, and highlight factors influencing therapeutic adherence.