Management of asthma patients in primary care settings: effect of a physician's training

Abstract

A cross-sectional analysis of management of asthma patients before and after short-term training of 78 physicians in Bishkek was performed. At baseline, diagnosis of asthma was made in 37 patients (4.1 % of all respiratory diseases). Just after training, in 1 year and in 2 years, asthma was diagnosed in 26, 45 and 26 patients, respectively. At baseline, peak flow measurement and spirometry were not used at all and treatment was mainly symptomatic. The training resulted in improvement of theoretical knowledge score from 84.6 % to 73.3 %; p < 0.001. Use of peak flow measurements increased to 38.5 %, 51.1 % and 38.5 % just after the training, in 1 and 2 years, respectively. Use of spirometry grew to 11.5 %, 17.8 % and 26.9 %, respectively. Inhaled corticosteroids (ICS) were administered to 42.3 %, 53.3 %, and 46.2 %, respectively, vs. 5.4 % at baseline with simultaneous reduction in inadequate administrations of vitamins, antibiotics and expectorants. So, the short-term training was effective. However, application of peak flow measurement in 100 % of the patients should be achieved; the majority of patients need ICS. Ways to increase the training efficiency are necessary.