Allergy in general practice in Arhus County. Quality assessment of diagnosis, treatment and instructions to patients: I. Asthma
Jensen, J.Korsgaard.; Jakobsen, M.Klitgaard.
Ugeskrift for laeger 168(13): 1326-1331
2006
ISSN/ISBN: 1603-6824 PMID: 16579888 Document Number: 603817
The aim of this study was to evaluate adult patients examined in general practice on suspicion of having asthma. A total of 46 patients suspected of having asthma underwent a second specialist investigation, which demonstrated that 28 of them had asthma. Through interviews of patients and a questionnaire completed by the primary physician, information on diagnostic strategy, general practice diagnosis, suggested treatments and patients' knowledge about asthma was determined. In 65% of the patients investigated for possible asthma in general practice, the specialist examination did not provide any major suggestions for changes, while one in every three patients would have benefited from a secondary specialist examination. The largest group was 7 of 18 patients who did not have asthma but who suffered from chronic or recurrent symptoms. Also, one in four of the patients with a final diagnosis of asthma would have benefited from a specialist examination because of uncertain diagnosis, disease severity and/or the possibility of allergen-specific treatment. The medical treatments suggested by the general practitioners followed modern treatment principles. Just over half of the patients with a final specialist diagnosis of asthma were familiar with the basic disease mechanisms, but only 7% of them would change their therapy in relation to disease severity without first contacting their physicians. Patients with chronic or recurrent symptoms should be referred to specialists more often, and patients who could potentially benefit from allergen-specific treatment, such as allergen prevention, should be evaluated by an allergy specialist. There is a need for increased patient education.