Profile and management of patients presenting with asthma in outpatients at a community hospital in Escourt.

Abstract

Much work has been done in urban areas to implement national guidelines in the treatment of asthma. There is however a dearth of studies done in rural and semi-rural areas. For this reason this study on the profile and management of patients presenting with asthma at a community hospital was undertaken in Estcourt. The study involved interviewing patients presenting with asthma at an outpatient clinic. The questionnaire and patient records were used. The questionnaire was designed by the author to detect precipitating factors leading to exacerbation of asthma and to assess whether national guidelines were been followed by doctors treating these patients. A hundred patients were interviewed. Eighty seven percent of these patients' treatments were not in keeping with national guidelines. In only 11 % of these patients had a doctor used a peak flow meter in the assessment of the patient. Three percent of patients had an understanding of their disease because of relatives who were medical workers. Patients complained that their illness was not explained to them and-they were not shown methods of coping with an acute attack. In many cases patients and health workers did not appreciate the seriousness of an attack. This is demonstrated by the study which showed seventy four percent of participants did not receive prophylactic treatment such as inhaled steroids or sodium chromoglycate although all were chronic sufferers of asthma. Of the thirty one patients admitted in 1997, twenty five had presented to outpatients in 1997 in the same month of their admission. This proves that the seriousness of their condition was not detected by the health workers attending to them. Recommendations are made in keeping with national guidelines to improve services in the Estcourt area in order to reduce morbidity and mortality in patients suffering from asthma and to increase patient satisfaction.