Inhaled steroid use in adult asthmatics--experience at a primary health care centre.

Abstract

To the Editor: Patient adherence to the correct dosage of inhaled corticosteroids may be as low as 38%, leading to further medical and social costs. 1-3 When correctly used, more than half of the costs of adding inhaled corticosteroids to inhaled β2-agonists are compensated for by a reduction in the costs of other health care services. 4 In South Africa the problem of non-adherence may be compounded by the poor quality of care offered by doctors and public sector clinics. 5 Another problem is that up to 82% of patients are not able to demonstrate adequate inhaler technique. 6 Although nearly twothirds of all medical visits for asthma are to primary care physicians, 7 little is known about primary care patients’ understanding of and adherence to prescribed treatment regimens. 2 The objectives of the study were to determine whether patients with chronic persistent asthma adhere to the prescribed dose of inhaled steroid, to assess the ability of patients to use the inhaler correctly, and to assess patient knowledge regarding the use of inhaled steroid as a preventive intervention. The study was conducted at Mitchell’s Plain Community Health Centre (MPCHC), which offers primary care services to a low socio-economic population in the Cape Town metropole. Ac ross-sectional survey was done of 268 patients who had been attending MPCHC for at least 6 months, who were aged at least 18 years, who had a diagnosis of asthma, and were on inhaled corticosteroids. The maximum number of asthmatic patients treated regularly at the MPCHC was estimated at 400 500 per month. Non-booked non-emergency and emergency