A Retrospective Study of ‘Operation Zero Asthma Death’ in the Tono District, Gifu Prefecture / 日本農村医学会雑誌

ABSTRACT

  Purpose and Background: To attain the goal of the “Operation Zero Asthma Death” implemented by the Ministry of Health, Labor and Welfare, it is essentially important to make the treatment guidelines known widely and make proper use of inhaled steroid drugs at an early stage. That said, in the area where specialists are in extremely short supply, there are limitations to the development of the operation. The Asthma Control Committee organized by the Tono Chapter of the Medical Association in Gifu Prefecture developed a four-layered system of its own for coordination between hospitals, clinics, drug stores and public care facilities. This year is the third year after the system was worked out. In the present study, we examined the results of the asthma control activities. Methods;In the first layer, hospitals and clinics jointly hold lecture meetings to familiarize the treatment guidelines through asthma cards;in the second layer, medical specialists and pharmacists held inhalation workshops for pharmacists in neighborhood drugstores; in the third layer, emergency paramedics joined forces, and in the forth layer, the aim was to build up a collaborative relationship with nursing care workers. The effects of these activities using the four-layered system on the Operation Zero Asthma Death were assessed in terms of the amount of inhaled steroid drugs prescribed and the change in the number of asthma deaths per 100,000 persons. Results: The amount of inhaled steroid drugs prescribed increased almost twice as much as before the start of these activities. It was found that the inhalation workshops were attended by almost all the druggists in the district, thus laying the foundation for the system of inhalation instruction. Through the nursing care support seminars, the collaborative relationship was established. The open lecture meeting held twice for ordinary people were very well attended, thus playing an important role in increasing the knowledge of asthma among the general public. The asthma deaths in the Tono district dramatically decreased from 4.13/100,000 persons for 1998 to 0.81/100,000 for 2008. The death ratio for 2008 was compared favorably with 1.17/100,000 in the whole prefecture for the same year. Conclusion: The results clearly indicated that the four-layered system worked out by the Asthma Control Committee could surely reduce the number of deaths from asthma even in the area where specialists are in short supply.