American Journal of Internal Medicine
Volume 8, Issue 1, January 2020, Pages: 45-50
Received: Feb. 9, 2020;
Accepted: Feb. 18, 2020;
Published: Feb. 28, 2020
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Yuriy Mostovoy, Propedeutic Department to the Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Vinnytsia, Ukraine
Anna Demchuk, Propedeutic Department to the Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Vinnytsia, Ukraine
Tetyana Konstantynovych, Propedeutic Department to the Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Vinnytsia, Ukraine
With purpose to assess the primary care for bronchial asthma (BA) patients the anonymous survey of 175 family doctors was performed. We established low percent (2,9%) of self-depended diagnosis of BA by family doctors. It showed their extremely poor role in the primary BA diagnosis. The most frequently diagnosis of BA made by pulmonologist or allergist (75,4%). The management of a patient with BA was performed by a family doctor in collaboration with allergist or pulmonologist in 53,2% of cases, 70% family doctors meet with BA patients for control of disease every 1-3 month. They prescribed correct basis therapy with inhaled corticosteroid (ICS) or combination of ICS with long-action beta agonist most of patients. Misinterpretation of asthma control are showed by most of family doctors. The vast majority of patients (98.8%) had at least one exacerbation of asthma per year. Only 25% of family doctors treated patients with BA exacerbation self-dependently. They used nebulization of high doses of bronchodilators and ICS for treatment of BA exacerbation in outpatient setting for 91,4% of cases. We found low level of prescriptions of systemic corticosteroids for treatment of BA exacerbations in outpatient setting and misunderstanding of systemic corticosteroid therapy. Family doctors need additional educational activities and monitoring adherence to national and international guidelines.
Management of the Bronchial Asthma Patients at Practice of Family Doctors, American Journal of Internal Medicine. Special Issue: New Approaches to Manage Difficult-to-Control, Severe Asthma.
Vol. 8, No. 1,
2020, pp. 45-50.
Comparative data about respiratory diseases and medical care for patients with diseases of pulmonology and allergology profile in Ukraine 2011 – 2018. National Academy of Medical Science of Ukraine, Medical Statistic Center of Ukraine Ministry of Health of Ukraine State Institution “National Institute of Physiatry and Pulmonology n.a. FG Yanovskiy National Academy of Medical Sciences of Ukraine ”Available from: http://www.ifp.kiev.ua/doc/staff/pulmukr2018.pdf.
Global Initiative for Asthma. Global Strategy for Asthma Management and prevention, 2019. Available from: www.ginasthma.org.
Order of Ukrainian Ministry of Health № 868 from 09.10.2013 Bronchial asthma. Adapted evidence-based clinical guidelines. Available from: www.moz.gov.ua/ua/portal/dn_20131008_0868.html.
Price D, Fletcher M, and van der Molen T. Asthma control and management in 8,000 European patients: the REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey. NPJ Prim Care Respir Med 2014; 24: 14009. Published online 2014 Jun 12. doi: 10.1038/npjpcrm.2014.9.
Boonsawat W, Thompson, PJ, Zaeoui U, Samosorn C, Faruqi R and Poonnoi P. Survey of asthma management in Thailand - the asthma insight and management study. Asian Pac J Allergy Immunol 2015; 33: 14-20 DOI 10.12932/AP04220.127.116.115.
Gebremariam TH, Binegdie AB, Mitiku AS, Ashagrie AW, Gebrehiwot KG, Huluka DK, Sherman CB, Schluger NW. Level of asthma control and risk factors for poor asthma control among clinic patients seen at a Referral Hospital in Addis Ababa, Ethiopia. BMC Res Notes. 2017 Nov 6; 10 (1): 558. doi: 10.1186/s13104-017-2887-z.
Torchyan A. A., Asthma control in Saudi Arabia: Gender implications Allergy Asthma Proc. 2017 May 1; 38 (3): 47-53. doi: 10.2500/aap.2017.38.4035.
Solé D, Sanchez Aranda C, and Wandalsen G F. Asthma: epidemiology of disease control in Latin America – short review. Asthma Res Pract. 2017; 3: 4. Published online 2017 May 11. doi: 10.1186/s40733-017-0032-3.
Bradley E. Chipps & Robert S. Zeiger & Alejandro Dorenbaum & Larry Borish & Sally E. Wenzel & Dave P. Miller & Mary Lou Hayden & Eugene R. Bleecker & F. Estelle R. Simons & Stanley J. Szefler & Scott T. Weiss & Tmirah Haselkorn. Assessment of asthma control and asthma exacerbations in the epidemiology and natural history of asthma: outcomes and treatment regimens (TENOR) observational cohort. Curr Respir Care Rep (2012) 1: 259–269 DOI 10.1007/s13665-012-0025-x.
Christensen GM, Tomasallo CD, Meiman JG Adult Asthma Control and Self-Management, Wisconsin 2012-2016. WMJ. 2019 Dec; 118 (4): 187-190.
Iikura M, Yi S, Ichimura Y, Hori A, Izumi S, Sugiyama H, Kudo K, Mizoue T, Kobayashi N. Effect of lifestyle on asthma control in Japanese patients: importance of periodical exercise and raw vegetable diet PLoS One. 2013 Jul 9; 8 (7): e68290. doi: 10.1371/journal.pone.0068290. Print 2013.
Calvo E, Trigueros JA, López A, Sánchez G Asthma сontrol in patients attending primary care in Spain (Actis study) Aten Primaria. 2017 Dec; 49 (10): 586-592. doi: 10.1016/j.aprim.2016.12.005. Epub 2017 Apr 12.
Bateman ED. Treatment adherence in asthmatic patients: the last frontier? J Allergy Clin Immunol. 2014; 134 (6): 1269-70.
Björnsdóttir US, Gizurarson S, Sabale U. Potential negative consequences of non-consented switch of inhaled medications and devices in asthma patients. Int J Clin Pract. 2013 Sep; 67 (9): 904–910.doi: 10.1111/ijcp.12202.
Gums TH, Milavets G, Carter B. L., Buys L. M. Physician-Pharmacist Collaborative Management of Asthma in Primary Care. Pharmacotherapy 34 (10), October 2014 DOI: 10.1002/phar.1468.
Ali A, Pena SG, Huggins C, Lugo F, Khaja M, Diaz-Fuentes G. Impact of Group Asthma Education on Asthma Control and Emergency Room Visits in an Underserved New York Community. Can Respir J. 2019 Oct 1; 2019: 5165189. doi: 10.1155/2019/5165189.
Reddel HK, Barnes DJ. Pharmacological strategies for self-management of asthma exacerbations Eur Respir J. 2006 Jul; 28 (1): 182-99.
McKeever T., Mortimer K., Andrew Wilson, M. D., Walker S, Brightling C, Skeggs, A, Pavord I, Price D, Duley L., Thomas M., Bradshaw L, Higgins B. Quadrupling Inhaled Glucocorticoid Dose to Abort Asthma Exacerbations. N Engl J Med 2018; 378: 902-910 DOI: 10.1056/NEJMoa1714257.
Abdullah A. Alangari. Corticosteroids in the treatment of acute asthma. Ann Thorac Med. 2014 Oct-Dec; 9 (4): 187-192; doi: 10.4103/1817-1737.140120.
Edmonds ML, Milan SJ, Brenner BE, Camargo CA Jr, Rowe BH. Inhaled steroids for acute asthma following emergency department discharge. Cochrane Database Syst Rev 2012; 12: CD002316.