Asthma management - opinion of family doctors and patient’s view

Abstract

One of the conditions for successful asthma treatment is constructive interaction between the patient and the doctor. To assess the cooperation between family doctors (FD) and asthmatic patients (AP) an anonymous survey of 175 FD and 178 AP was conducted regarding diagnosis, use of basic and relief treatment, and understanding of asthma control. It was found the diagnosis of asthma in most cases was established by allergist or pulmonologist (according to 86.3% of FD and 44.9% of AP, p <0.001), although AP more often indicated the primary diagnosis of asthma during hospitalization (28.2%) or by FD (26.9%). Most of the AP visited their FD only due to exacerbation (35.9%) or no more than once a year (25.6%). FD noted regular contacts at least once a quarter (69.7%). Both groups (91.1% of FD and 87.2% of AP) noted basic asthma therapy included inhaled corticosteroids (ICS) or a combination of ICS and long-acting beta-agonists. Good asthma control was achieved in 63.9% cases on FD’s opinion but only 26.9% AP noted it and confirmed by the AST. FD noted annual exacerbations of asthma in 98.8% of AP, while only 78.2% of AP had exacerbations during the year. Asthma exacerbations was treated more often on an outpatient basis. Most FD indicated self-dependent or together with a pulmonologist (44.8%) treatment of asthma exacerbations, but the majority of AP preferred treatment with a specialist (61.6%). Thus, the diagnosis and therapy of asthma in the primary care corresponds to modern guidelines. AP adhere to basic asthma treatment and adequately assess the level of disease control. FD incorrectly understand asthma control, which requires additional educational activities.