To Study the Gap between Guidelines and Clinical Practice and Barriers to Asthma Management in Primary Care Practice
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 4
Abstract
Asthma causes significant morbidity and mortality in India where its prevalence is about 2%. Generally primary care physicians are responsible for management of asthma and this study aims to document the gap between guidelines and clinical practice. OPD patients of stable asthma were audited prospectively for diagnostic criteria, treatment profile and status of control, inhaler techniques and barriers to adequate control. Results were analyzed on percentage scale. 114 (44.7% males & 55.3% females) stable asthma patients completed the study. Asthma was diagnosed clinically in 74.6% patients, by peak flow meter in 17.5% and 7.9% by spirometry. 71.9% patients used oral medications, 26.3% inhalers and 1.8% used nebulizers. 22.8% patients were having adequate control and 77.2% had inadequate control of asthma. 27.2% patients were taking oral B-agonists, 34.2% methylxanthines and 10.5% were on combination of oral B-agonists and methylxanthines. Patients on inhalers included 6.1% on SABA inhaler, 3.5% on ICS, and 10.5% on ICS-SABA combination, 7.0% on ICS-LABA and 0.9% patient was on ICS-LABA-LAMA combination. Among the causes for inadequate control of asthma insufficient dose was the cause among 60.5% patients, irregular dose 57.0%, unacceptability of inhalers 27.2%, did not know about inhalers 30.7% and faulty inhaler technique was the cause in 16.7% patients. There is a wide gap between the guidelines and actual clinical practice in management of stable asthma and we recommend larger studies also exploring the barriers to management of stable asthma according to the guidelines.
Authors and Affiliations
Gupta Vitull K, Kaur Navjot, Wander Gurleen, Sidhu Tanvir Kau, Arora Sonia, Goel Siddharth
Keywords
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