Exploring the psychological impact of the COVID-19 pandemic on adults with asthma: a qualitative study

Aim: People with severe asthma are at high-risk of becoming seriously ill with COVID-19. In the UK, this population were advised to observe strict ‘shielding’ guidance during the pandemic. Despite early concerns, those with milder asthma do not appear to be high-risk, but confusion from changing thresholds for risk groups and unclear messages has led to uncertainty and overestimation of risk amongst many people with asthma. We wanted to explore the experiences of people with asthma during the COVID-19 pandemic. Methods: We recruited 26 adults (15 female; 11 male) with GP-diagnosed asthma from across the UK via the Register for Asthma researCH and Asthma UK social media. Interviews were conducted by phone in May/June 2020, audio-recorded, transcribed verbatim and analysed thematically. Results: Themes clustered around health communications; interaction with healthcare; impact on mental health. Most participants felt overwhelmed and confused by the amount of information on COVID-19 received via Government, media, social media channels. Asthma UK’s website and Facebook page were mentioned by almost all participants as their primary source for “trusted” information. Aside from shielding letters, many participants reported not being contacted by their GP practice during the pandemic. Those who had remote-consultations were positive about the experience but highlighted the importance of a pre-existing relationship with the clinician. The impact of the lockdown guidelines affected participants’ mental health with most participants mentioning either increased anxiety, fear of death, loneliness and grief. The pandemic increased adherence to preventer inhalers in some participants with most mentioning they were more aware of their asthma symptoms. Conclusions: People with asthma experienced confusion, fear, anxiety and loneliness during the COVID-19 pandemic. Clearer guidelines and support from the Government and healthcare providers may reduce the psychological distress in individuals with respiratory conditions in the event of a second wave of COVID-19 and/or future pandemics. Implementation Science/Service Development Research Ideas on Respiratory Conditions and Tobacco Dependency Abstract Declaration of Interest Funding: This project received no funding.Disclosure: T.Jackson is funded by Asthma UK as part of the Asthma UK Centre for Applied Research [AUK-AC-2012-01 and AUK-AC-2018-01]. K.McClatchey and B.Delaney are supported by the National Institute for Health Research (NIHR) IMP2ART (IMProving IMPlementation of Asthma self-management as RouTine) programme of work (RP-PG-1016-20008). A.Chan reports grants from Innovate UK, A+ charitable trust (Auckland District Health Board), Maurice and Phyllis Paykel trust, Universitas 21, New Zealand Pharmacy Education Research Fund, Auckland Academic Health Alliance, Asthma UK, University of Auckland; reports consultancy fees from Janssen-Cilag and UCL-Business spin-out company Spoonful of Sugar Ltd. References and Clinical Trial Registry Information