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Management of the Bronchial Asthma Patients at Practice of Family Doctors

Received: 9 February 2020     Accepted: 18 February 2020     Published: 28 February 2020
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Abstract

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.

Published in American Journal of Internal Medicine (Volume 8, Issue 1)

This article belongs to the Special Issue New Approaches to Manage Difficult-to-Control, Severe Asthma

DOI 10.11648/j.ajim.20200801.19
Page(s) 45-50
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Bronchial Asthma, Primary Care, Treatment, Asthma Control, Exacerbation

References
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[2] Global Initiative for Asthma. Global Strategy for Asthma Management and prevention, 2019. Available from: www.ginasthma.org.
[3] 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.
[4] 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.
[5] 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/AP0473.33.1.2015.
[6] 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.
[7] 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.
[8] 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.
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[10] Christensen GM, Tomasallo CD, Meiman JG Adult Asthma Control and Self-Management, Wisconsin 2012-2016. WMJ. 2019 Dec; 118 (4): 187-190.
[11] 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.
[12] 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.
[13] Bateman ED. Treatment adherence in asthmatic patients: the last frontier? J Allergy Clin Immunol. 2014; 134 (6): 1269-70.
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    Yuriy Mostovoy, Anna Demchuk, Tetyana Konstantynovych. (2020). Management of the Bronchial Asthma Patients at Practice of Family Doctors. American Journal of Internal Medicine, 8(1), 45-50. https://doi.org/10.11648/j.ajim.20200801.19

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    ACS Style

    Yuriy Mostovoy; Anna Demchuk; Tetyana Konstantynovych. Management of the Bronchial Asthma Patients at Practice of Family Doctors. Am. J. Intern. Med. 2020, 8(1), 45-50. doi: 10.11648/j.ajim.20200801.19

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    AMA Style

    Yuriy Mostovoy, Anna Demchuk, Tetyana Konstantynovych. Management of the Bronchial Asthma Patients at Practice of Family Doctors. Am J Intern Med. 2020;8(1):45-50. doi: 10.11648/j.ajim.20200801.19

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  • @article{10.11648/j.ajim.20200801.19,
      author = {Yuriy Mostovoy and Anna Demchuk and Tetyana Konstantynovych},
      title = {Management of the Bronchial Asthma Patients at Practice of Family Doctors},
      journal = {American Journal of Internal Medicine},
      volume = {8},
      number = {1},
      pages = {45-50},
      doi = {10.11648/j.ajim.20200801.19},
      url = {https://doi.org/10.11648/j.ajim.20200801.19},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20200801.19},
      abstract = {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.},
     year = {2020}
    }
    

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    AB  - 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.
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Author Information
  • Propedeutic Department to the Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Vinnytsia, Ukraine

  • Propedeutic Department to the Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Vinnytsia, Ukraine

  • Propedeutic Department to the Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Vinnytsia, Ukraine

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