Abstract
With purpose to assess the primary care for bronchial asthma (BA) patients the anonymous survey of 175 family doctors was performed. We established low percent (2,9%) of self-depended diagnosis of BA by family doctors. It showed their extremely poor role in the primary BA diagnosis. The most frequently diagnosis of BA made by pulmonologist or allergist (75,4%). The management of a patient with BA was performed by a family doctor in collaboration with allergist or pulmonologist in 53,2% of cases, 70% family doctors meet with BA patients for control of disease every 1-3 month. They prescribed correct basis therapy with inhaled corticosteroid (ICS) or combination of ICS with long-action beta agonist most of patients. Misinterpretation of asthma control are showed by most of family doctors. The vast majority of patients (98.8%) had at least one exacerbation of asthma per year. Only 25% of family doctors treated patients with BA exacerbation self-dependently. They used nebulization of high doses of bronchodilators and ICS for treatment of BA exacerbation in outpatient setting for 91,4% of cases. We found low level of prescriptions of systemic corticosteroids for treatment of BA exacerbations in outpatient setting and misunderstanding of systemic corticosteroid therapy. Family doctors need additional educational activities and monitoring adherence to national and international guidelines.
Highlights
Effective management of patients with bronchial asthma (BA) is one of the most important problem of modern family medicine which is caused by the significant spread of the disease in Ukraine (0, 5%) and in the world [1, 2].2
The diagnosis of asthma in most cases was established by specialists - allergist or pulmonologist or in cooperation with the allergist/pulmonologist and family doctor (Table 1)
Group of doctors according to duration of practice < 5 years (n=36) 5-25 years (n=69) >25 years (n=70) Total (n=175) Р
Summary
Effective management of patients with bronchial asthma (BA) is one of the most important problem of modern family medicine which is caused by the significant spread of the disease in Ukraine (0, 5%) and in the world (from 1% to 18%) [1, 2]. An institution of the family doctors has been created. Their responsibilities are providing outpatient medical care to all sections of the population, from newborns to the elderly. Doctor should use the international (GINA 2019) or national guidelines Adapted evidence-based clinical guidelines) grounded on the modern evidence-based medicine for effective management of the BA patients [2, 3]
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