Abstract
Background: Due to inadequate health resources in India the peripheral health services are provided by unqualified practitioners who are unaware of management protocols. This study attempts to assess the practices at primary care level
Method: 200 patients of Asthma were diagnosed and selected for the study. Data was collected by interview at a tertiary care center and by auditing the prescriptions of the practitioners
Observation: Of the 200 patients in the study 70.2% were previously diagnosed as asthma of which only 3.38% had undergone spirometry. 16.7% of the subjects were being treated by unqualified practitioners, while 38% and 44% by GPs (medical graduate) and physician (PG degree) respectively. 93% patients treated by the unqualified practitioners were uncontrolled or partially controlled. Among those treated by unqualified practitioners 64.3% were being inappropriately prescribed oral bronchodilators and oral steroids. Subjects treated by physicians received appropriate treatment with 81.1% and 67.6% receiving inhaled beta2 agonist and inhaled steroids respectively. GPs prescribed inappropriate treatment in a higher proportion (63%) and prescribed medications like oral steroids (34.4%), oral beta2 agonists (34.4%) and thoephylline (38.8%). Only 15.5% of the subjects were being monitored by PEFR
Conclusion: Asthmatics in India are being inadequately diagnosed, treated and monitored. Major reason is the poor understanding of practitioners especially with the guidelines –GINA especially in the case of unqualified practitioners and GPs. There is need to educate the practitioners particularly those at the periphery about the guidelines for asthma management.
- © 2011 ERS