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

¹ Pharmacoepidemiology Unit, ² Respiratory Medicine, CHU-Lyon, and ⁴ Faculty of Pharmacy, Claude-Bernard University, Lyon, France. ³ University of Aberdeen, Aberdeen, UK.

CORRESPONDENCE: E. Van Ganse, Unité de Pharmacoépidémiologie, EA3091, Ste Eugénie (5F) Centre Hospitalier Lyon-Sud, F-69495 Pierre-Bénite Cedex, France. Fax: 33 472666444. E-mail: eric.van-ganse{at}chu-lyon.fr

Keywords: Asthma, control, primary care, supervision

Received: March 25, 2005
Accepted August 5, 2005

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.

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