Management of asthma in patients supervised by primary care physicians or by specialists

被引:41
作者
Laforest, L
Van Ganse, E
Devouassoux, G
Chretin, S
Osman, L
Bauguil, G
Pacheco, Y
Chamba, G
机构
[1] CHU Lyon, Pharmacoepidemiol Unit, Lyon, France
[2] Univ Lyon 1, Fac Pharm, F-69365 Lyon, France
[3] Univ Aberdeen, Aberdeen, Scotland
关键词
asthma; control; primary care; supervision;
D O I
10.1183/09031936.06.00035805
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
French asthma patients may be supervised by general practitioners (GPs) and/or specialists. Therefore, this study examined asthma management in patients exclusively supervised by specialists (SPE), GPs, (GP) and both (GP+SPE group), and compared the findings. Asthma patients were consecutively recruited in 348 pharmacies. Each patient completed a questionnaire providing data on personal characteristics, asthma management, perception of disease and asthma supervision. Asthma control was measured using the Asthma Control Test. Questionnaires were linked to computerised records of medications which had been dispensed before inclusion in the study. From the 1,256 patients (mean age=36.1 yrs, 54.3% females), 11.4, 36.6, and 52.0% were placed in the SPE, GP, and GP+SPE groups, respectively. During the previous 4 weeks, most patients in the SPE group were properly controlled (52.2 versus 26.4 and 21.5% in GP and GP+SPE groups, respectively). The SPE group made more use of fixed combinations of long-acting beta agonist and inhaled corticosteroid, while receiving less short-acting beta agonists, antitussives and antibiotics. Striking differences in symptoms and asthma management were observed according to the type of asthma supervision. The current results strongly support the need to improve the management of asthma in primary care, and the coordination of care between general practitioners and specialists.
引用
收藏
页码:42 / 50
页数:9
相关论文
共 20 条
[1]   Factors associated with hospital admissions and repeat emergency department visits for adults with asthma [J].
Adams, RJ ;
Smith, BJ ;
Ruffin, RE .
THORAX, 2000, 55 (07) :566-573
[2]   Influence of cigarette smoking on inhaled corticosteroid treatment in mild asthma [J].
Chalmers, GW ;
Macleod, KJ ;
Little, SA ;
Thomson, LJ ;
McSharry, CP ;
Thomson, NC .
THORAX, 2002, 57 (03) :226-230
[3]   The management of asthma: A case-scenario-based survey of family physicians and pulmonary specialists [J].
Cicutto, LC ;
Llewellyn-Thomas, HA ;
Geerts, WH .
JOURNAL OF ASTHMA, 2000, 37 (03) :235-246
[4]   The addition of salmeterol to fluticasone propionate versus increasing the dose of fluticasone propionate in patients with persistent asthma [J].
Condemi, JJ ;
Goldstein, S ;
Kalberg, C ;
Yancey, S ;
Emmett, A ;
Rickard, K .
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, 1999, 82 (04) :383-389
[5]   Influence on asthma morbidity of asthma education programs based on self-management plans following treatment optimization [J].
Cote, J ;
Cartier, A ;
Robichaud, P ;
Boutin, H ;
Malo, JL ;
Rouleau, M ;
Fillion, A ;
Lavallee, M ;
Krusky, M ;
Boulet, LP .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1997, 155 (05) :1509-1514
[6]   Asthma economics: focusing on therapies that improve costly outcomes [J].
Gendo, K ;
Lodewick, MJ .
CURRENT OPINION IN PULMONARY MEDICINE, 2005, 11 (01) :43-50
[7]   Management of acute asthma attacks associated with respiratory tract infection: A postal survey of general practitioners in the UK [J].
Jones, K ;
GruffyddJones, K .
RESPIRATORY MEDICINE, 1996, 90 (07) :419-425
[8]   Impact of respiratory symptoms on health-related quality of life and medical resource utilization of patients treated by allergy specialists and primary care providers [J].
Kanter, LJ ;
Siegel, CJ ;
Snyder, CF ;
Pelletier, EM ;
Buchner, DA ;
Goss, TF .
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, 2002, 89 (02) :139-147
[9]   Salmeterol and fluticasone propionate combined in a new powder inhalation device for the treatment of asthma: A randomized, double-blind, placebo-controlled trial [J].
Kavuru, M ;
Melamed, J ;
Gross, G ;
LaForce, C ;
House, K ;
Prillaman, B ;
Baitinger, L ;
Woodring, A ;
Shah, T .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2000, 105 (06) :1108-1116
[10]  
Kljakovic M, 1998, BRIT J GEN PRACT, V48, P1773