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Suboptimal asthma control: prevalence, detection and consequences in general practice.

https://arctichealth.org/en/permalink/ahliterature160627
Source
Eur Respir J. 2008 Feb;31(2):320-5
Publication Type
Article
Date
Feb-2008
Author
K R Chapman
L P Boulet
R M Rea
E. Franssen
Author Affiliation
University of Toronto, Canada. kchapman@ca.inter.net
Source
Eur Respir J. 2008 Feb;31(2):320-5
Date
Feb-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anti-Asthmatic Agents - therapeutic use
Asthma - diagnosis - drug therapy - epidemiology
Attitude of Health Personnel
Bronchodilator Agents - therapeutic use
Chi-Square Distribution
Confidence Intervals
Cross-Sectional Studies
Family Practice - standards - trends
Female
Humans
Logistic Models
Male
Middle Aged
Odds Ratio
Office visits - statistics & numerical data
Ontario - epidemiology
Patient satisfaction
Physician's Practice Patterns - statistics & numerical data
Physician-Patient Relations
Prevalence
Questionnaires
Respiratory Function Tests
Risk assessment
Severity of Illness Index
Treatment Outcome
Abstract
Telephone surveys describing suboptimal asthma control may be biased by low response rates. In order to obtain an unbiased assessment of asthma control and assess its impact in primary care, primary care physicians used a 1-page control questionnaire in 50 consecutive asthma patients. Of the 10,428 patients assessed by 354 physicians, 59% were uncontrolled, 19% well-controlled and 23% totally controlled. Physicians overestimated control, regarding only 42% of patients as uncontrolled. Physicians were more likely to report plans to alter the regimens of uncontrolled patients than controlled patients (1.29 versus 0.20 medication changes per patient) doing so in a fashion consistent with guideline recommendations. Of the uncontrolled patients, 59% required one or more urgent care or specialist visits versus 26 and 15% of well-controlled or totally controlled patients, respectively. Patients were more likely to report short-term symptom control when they had not required urgent or specialist care (odds ratio 5.68; 95% confidence interval 4.91-6.58). The majority of asthma patients treated in general practice are uncontrolled. Lack of control can be recognised by physicians who are likely to consider appropriate changes to therapy. A lack of short-term symptom control of asthma is associated with excess healthcare utilisation.
Notes
Comment In: Eur Respir J. 2008 Feb;31(2):229-3118238943
PubMed ID
17959642 View in PubMed
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