Regular use or on demand of inhaled corticosteroids for the management of asthma among Libyan patients in Tripoli

Abstract

Background: A step-wise approach for the use of inhaled corticosteroids (ICSs) in the management of bronchial asthma is recommended by all the medical guidelines. However, often, ICS are used intermittently by patients and/or recommended by physicians to be used during the onset of exacerbations. Hence, the present study was aimed to evaluate whether Libyan asthmatic patients are using ICS regularly or on demand and their outcomes. Methods: The present study was conducted in Tripoli city, along a period of 10 months, May 2013–February 2014. Three hundred patients of either sex recruited from different areas of Tripoli City, diagnosed with asthma and received treatment at Tripoli Medical Center and Abouseta Hospital were participated in this study. Results: The mean age of patients (±standard deviation) was 51 years (±29.1). Our results showed that 156 patients (52%) used ICS regularly (male: 35% and female: 65%), whereas 48% (144 patients) used ICS only during attack (male: 35% and female: 65%). Of the total participants, 61% of patients stated that they had asthmatic exacerbation symptoms within 1 month after discontinued ICS use (male: 32% and female: 68%). Furthermore, 39% of patients reported that they experienced the first exacerbation of symptom after 30 days of ceased ICS use (male: 38% and female: 62%). Exposure to cold, contact with dust, and inhaler misuse were the most common reported causes of exacerbations, respectively by 71% (212 patients), 12% (37 patients), and 5% (15 patients). Conclusion: The present findings demonstrate that, practically, half of the Libyan asthmatic patients, living in Tripoli city, are using ICS on demand and few of them had experienced asthma exacerbations after ICS pause use. Hence, in order to reduce the long-term exposure to ICS and patients' cost, our present study suggests, in contrast to international standards of asthma care, the use of ICS just during attack as a new potential treatment option.