Improvement in symptoms and pulmonary function of asthmatic patients due to their treatment according to the Global Strategy for Asthma Management (GINA)

Mohammad H Boskabady,Najmah Rahimi,Damon Dehnavi,Fariba Rezaeitalab

doi:10.1186/1471-2466-8-26

Mohammad H Boskabady, Najmah Rahimi + Show 2 more

Open Access

https://doi.org/10.1186/1471-2466-8-26

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Journal: BMC Pulmonary Medicine	Publication Date: Dec 1, 2008
Citations: 18	License type: CC BY 2.0

Affiliation: Mashhad University of Medical Sciences

Abstract

BackgroundGlobal Initiative Strategy for Asthma Management (GINA) is poorly applied in undeveloped and developing countries. The current study examined the effects of applying GINA guidelines on treatment efficacy in asthmatic patients in Iran.MethodsTwenty four asthmatic patients (usual care group) were treated as usual and 26 patients (intervention group) according to the GINA for 2 months. Asthma symptom score, asthma severity, frequency of symptoms/week and wheezing were recorded at the beginning (first visit), one month after treatment (second visit), and at the end of the study (third visit). Pulmonary function tests (PFTs) were performed by spirometry, and the patients' use of asthma drugs and their symptoms were evaluated, at each visit.ResultsAsthma symptoms, frequency of symptoms/week, chest wheezing, and PFT values were significantly improved in the intervention group at the second and third visits compared to first visit (p < 0.001 for all measures). In addition, exercise induced cough and wheeze were significant improved in the third visit compared to the second visit in this group (p < 0.01 for both measures). In the second and third visits all symptoms were significantly lower, and PFT values higher, in the intervention group compared to the usual care group (p < 0.005 to p < 0.001). In the usual care group, there were only small improvements in some parameters in just the second visit (p < 0.01 for all measures). The use of asthma drugs was unchanged in the usual care group and significantly reduced in the intervention group (p < 0.01) by the end of the study.ConclusionAdoption of GINA guidelines improves asthma symptoms and pulmonary function in asthmatic patients in Iran.

Highlights

Global Initiative Strategy for Asthma Management (GINA) is poorly applied in undeveloped and developing countries
Asthma symptoms All symptom scores of asthmatic patients treated according to GINA guidelines were improved even after 1 month's treatment and at the end of the study (third visit, (p < 0.001 for all cases)
Asthma symptoms were not different between the intervention and usual care groups at the start of the study and were significantly reduced in the intervention group compared to the usual care subjects at the second and third visits (p < 0.005 to p < 0.001), (Table 2)

Summary

Introduction

Global Initiative Strategy for Asthma Management (GINA) is poorly applied in undeveloped and developing countries. The current study examined the effects of applying GINA guidelines on treatment efficacy in asthmatic patients in Iran. Asthma affects over 10% of children and over 5% of adults in many European countries, and imposes a large burden on health services provision [1]. In Iran asthma affects 4.2% of children [3] and 2.8% of adults [4]. Sensitive indices of asthma severity including quality-of-life measurements, measurement of bronchial reactivity, or a measure of airway inflammation may be accessible to some types of health care services in developing countries. Lack of accessible guidelines, some medications and perhaps spirometry in developing countries making it difficult to assess asthma severity and achievement of optimal treatment. Asthma symptoms are often underestimated, leading to inadequate therapy [3]

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