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The European Federation of Allergy and Airways Diseases Patients’ Associations (EFA) is an alliance of 42 allergy, asthma and COPD patients’ organizations in 25 European countries. It has published a study of current limitations in access to healthcare for asthma and COPD patients to inform stakeholders so initiatives can be taken to fill existing and persisting gaps. 32 February 2020 Inhalation Back Page Study conclusions e report included detailed find- ings in more than 30 categories, as well as overall conclusions, which are briefly listed here. Diagnosis and treatment. e conclusions state that "diagnos- tic processes are ineffective" and that "asthma and COPD patients generally receive a late diagnosis. On average, it takes more than three years for asthma and COPD patients to receive a first diagno- sis after noticing symptoms." In addition, treatment options fail to prevent the worsening of patients' conditions. is contributes to hospital visits, especially for those with severe disease. Access to care. Usually, general practitioners and pulmonologists are involved in care. Patient access to them and to specialists is good, except for patients living in rural areas. However, "some patients do not involve a specialist mainly because they do not feel the need or because it was not suggested by their general practitioner." Payments. Patients do not need to pay for most of the services they use but most likely pay for pre- scriptions, medical devices, medi- cal aids and transportation. Response by public authorities. Patients are aware of individual risk factors, triggers and air pol- lutants but believe authorities are "doing too little to avoid public exposure to common risk factors." Patients particularly want authori- e European Federation of Allergy and Airways Diseases Patients' Associations (EFA) is an alliance of 42 allergy, asthma and COPD patients' organizations in 25 European countries. Its vision is that European patients with allergy, asthma and chronic obstructive pulmonary disease (COPD) live uncompromised lives, have the right and access to the best qual- ity care, and a safe environment. Its mission is to be their voice and actively involved in the decisions impacting their health. e EFA has conducted and pub- lished a study of current limita- tions in access to healthcare for asthma and COPD patients to inform stakeholders so initiatives can be taken to fill existing and persisting gaps. e study included 774 patients with mild, moderate and severe asthma and COPD, from Finland, France, Germany, Italy, Poland, Spain and the United Kingdom. Participants were interviewed by phone between November 2018 and January 2019. e findings have been pub- lished in e Active Asthma and COPD Patients Access Care Report and provide an overview of patient-reported levels of access to prevention, diagnosis, care and empowerment. In addition, the report provides recommendations for healthcare providers and sys- tems, policy makers and payers, as well as patients and researchers. The EFA's Active Asthma and COPD Patients ACCESS Care Report ties to reduce city air pollution and particulate matter from traffic. In addition, they believe authorities are not sufficiently promoting fac- tors that could improve patients' health, such as access to real-time air quality information. Empowerment. Opportunities for patient empowerment were "low" and they are "not involved enough in decision-making over treatments. Written management plans are available for only 30% and only 20% are involved in Disease Management Programs." However, most patients "feel well-informed about their disease and sufficiently trained." Patients also believe that asthma and COPD are "not getting enough attention compared to other chronic diseases and that better diagnostic tools and more efficient therapies are needed." In addition, their involvement in medical research is "fairly low" but half are "willing to share their clinical data with researchers and healthcare professionals." Study recommendations e report also provided numer- ous recommendations for those involved in diagnosis, care, pre- vention and empowerment of people with asthma and COPD in Europe. e recommendations were divided in groups by audi- ence, some labeled with the theme "showleadership." An edited over- view is provided here: continued on page 31