[Monitoring of asthma outpatients after adapting treatment to meet international guidelines]

Abstract

Objective: Poor control of asthma treated in outpatient settings has been demonstrated. The aim of this study was to perform a short intervention, readily replicable in everyday practice, to try to improve control of the disease.

Patients and methods: Two primary health care clinics made appointments with asthma patients to administer a questionnaire and adapt their treatment to the guidelines of the Global Initiative for Asthma. Patients also received an explanation of the disease lasting not more than 5 minutes. The protocol was repeated at a second visit 4 months later. Health care parameters were compared with those from the previous visit.

Results: The characteristics of the 180 patients were as follows: 70% were women, 17% were smokers, 8% were illiterate, 46% had only primary education, 45% were in contact with cleaning products, and 63% had extrinsic asthma. The asthma severity was as follows: mild in 73%, moderate in 23%, and severe in 4%. Twenty-two percent had received previous explanations of the disease, 50% had a written treatment plan, 14% had a plan for exacerbations, and 54% were taking inhaled corticosteroids. The second appointment was kept by 110 (61%) of the patients, who showed differences with respect to the previous visit 4 months earlier in the percentage taking inhaled corticosteroids (78%, P< .001), the number of visits to the physician (P< .01), visits to the physician due to exacerbations (P< .001), emergency visits to the outpatient clinic (P< .002), and disease severity (P< .02).

Conclusions: This minimal clinical intervention reduced the need for visits to health care centers and improved the control of asthma symptoms.