ArticleAtencion primaria2006
[Primary care asthma treatment: Are we following international consensus (GINA 2002)?].
Article in Atencion primaria, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo check whether treatment of asthma patients at our centre coincides with international criteria (GINA 2002).
designTransversal, descriptive study.
settingUrban primary care team.
participantsAsthma patients over 14 years old. MAIN MEASUREMENTS: Review of clinical histories (CH) and analysis of the last prescription between November 2002 and May 2003.
resultsWe reviewed 436 CH, of which 395 made up the study group. 71.4% (SD, 66.9-75.8) were women. Average age was 51.4 (SD, 49.2-53.6). Classification of asthma as function of gravity was: intermittent (IA): 30% (25.7-34.3); light persistent (LPA): 24.8% (20.7-28.8); moderate persistent (MPA): 30.7% (26.4-35.1); serious persistent (SPA): 5.05% (3.19-7.54). Unclassified: 9.4% (6.83-12.5). Correct treatment: IA, 69.5% (61.6-77.4); LPA, 22.2% (14.4-30.1); MPA, 46.2% (7.8-54.7); SPA, 72.7% (49.8-89.3). The most common cause of incorrect treatment in all kinds of asthma was the use of international criteria (IC) at inadequate doses: IA, 47.5% (31.5-63.9); LPA, 73.8% (63.1-82.8); MPA, 38.9% (27.6-51.1); SPA, 33.3% (4.3-77.7). The scant use of B2CD.AD was noticeable: IA, 47.5% (31.5-63.9); LPA, 85.7% (76.4-92.4); MPA, 86.7% (74.3-92.1); SPA, 66.7% (22.3-95.7). The most commonly used active principles were salbutamol, salmeterol, budesonide, and montelukast. On overall measurement of good treatment, we found that 48.9% (n = 193) of patients had a correct prescription.
conclusionsIn primary care, light forms of asthma are most commonly monitored. We found low concordance with the GINA 2002 directives. IC are widely used, but often at incorrect doses. We insist on the importance of classifying asthma according to its gravity in order to prescribe the right treatment.
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