Relation between morbidity and current treatment in patients who present with acute asthma to polyclinics
Tan, N.C.; Goh, S.; Leong, H.; Ng, C.J.; Thai, V.; Siew, W.F.; Emmanuel, S.; Lim, T.K.
Singapore Medical Journal 41(6): 259-263
2000
ISSN/ISBN: 0037-5675 PMID: 11109340 Document Number: 524548
Background: It has been suggested that resources for asthma intervention should be focused mainly on patients in the community who experience a high burden of disease. These are who patients who have acute exacerbations which require urgent treatment. Aim: To assess the morbidity and identify deficiencies in the treatment of patients who present for urgent treatment of acute exacerbations to primary care clinics. Patients: Adult patients who received urgent treatment for acute exacerbation of bronchial asthma. Setting: 4 primary care polyclinics Methods: A cross-sectional survey of consecutive patients which related regular preventive treatment to current asthma activity. Poor asthma control was defined as step 2 or higher (American National Asthma Education and Prevention Program, report 11, 1997) or gtoreq2 emergency room visits in 6 months. Results: There were 116 patients of whom 53% were women. The mean (SD) age was 45 (15) years and duration of current exacerbation 3 (3) days. The acute symptoms were successfully treated in 93% of patients. Quick relief medication was used regularly in 91% and inhaled corticosteroids (ICS) in 55%. Oral salbutamol was prescribed in 14% of patients. The asthma was poorly controlled in 54%. In the poorly controlled group 33% were not on regular ICS treatment and 64% were not receiving "add on" medication. Conclusions: Patients treated for acute asthma in primary care clinics: (1) were older and had less acutely severe exacerbations than those who presented to emergency rooms, (2) over half had poorly controlled asthma and (3) a third of patients with poor asthma control were inadequately treated.