Impact of adherence to Asthma management guidelines in asthmatic patients: a primary healthcare center study

ABSTRACT

To study the effect of adherence to asthma management guidelines on the control of asthma symptoms and the results of peak expiratory flow rate [PEFR] in asthmatic patients Cross sectional study Asthma clinic at Khalidiya Health Care Center A convenience sample of 162 asthmatic Kuwaiti patients aged between four and 83 years were interviewed through a structured questionnaire. Out of 162 patients, 140 participants [86.4%] reported not using controller medication. One hundred and five participants [64.8%] fit in the category of uncontrolled asthma. Only 21 participants [13.0%] were on controller medication prior to the study. All participants who were on controller treatment, got their prescription by a specialist. The difference between the two proportions was significant at p < 0.0001. Of the 162 participants, only 28 cases [17.3%] did not require alteration of their management plan. The remaining 134 participants required changes to their original management plan either by adjusting the dose of their medication or adding controller medication in the form of separate or combined therapy. There was a significant improvement in the PEFR after applying the new management plan with median of actual PEFR 350 in comparison to 390 two weeks later, after applying the new management plan [p < 0.001]. Despite evidence that adherence to asthma management guideline improves outcome, general practitioners are reluctant to prescribe controller medication