Abstract
Implementing asthma guideline recommendations is challenging in low- and middle-income countries. We aimed to explore healthcare provider (HCP) perspectives on the provision of recommended care. Twenty-six HCPs from six public primary care clinics in a semi-urban district of Malaysia were purposively sampled based on roles and experience. Focus group discussions were guided by a semi-structured interview guide and analysed thematically. HCPs had access to guidelines and training but highlighted multiple infrastructure-related challenges to implementing recommended care. Diagnosis and review of asthma control were hampered by limited access to spirometry and limited asthma control test (ACT) use, respectively. Treatment decisions were limited by poor availability of inhaled combination therapy (ICS/LABA) and free spacer devices. Imposed Ministry of Health programmes involving other non-communicable diseases were prioritised over asthma. Ministerial policies need practical resources and organisational support if quality improvement programmes are to facilitate better management of asthma in public primary care clinics.
Highlights
Asthma is a common chronic respiratory disease globally, including in low- and middle-income countries (LMICs)[1]
The objective of this study is to explore the challenges and potential enablers faced by healthcare providers (HCPs) in public primary care clinics in Malaysia for providing asthma care
Medicine specialist Though the participants agreed that having a dedicated asthma clinic could facilitate asthma care, they felt that the once-a-week
Summary
Asthma is a common chronic respiratory disease globally, including in low- and middle-income countries (LMICs)[1]. It affects all age groups and about 235 million people are living with asthma worldwide[1]. Asthma control is reported to be poor[3,4], there is variation according to regions. High-income countries such as Australia, United Kingdom and United States have reported rates of about 50% of patients with asthma as being well controlled[5,6,7]. In the Asia-Pacific region, only 7.6% of patients with asthma aged ≥12 years were well controlled[4]
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