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Eur Respir J 2006; 27:1071
Copyright ©ERS Journals Ltd 2006

From the authors

E. Van Ganse and L. Laforest

Unit of Pharmacoepidemiology, CHU Lyon Sud, Pierre-Benite, France.

We would like to respond to G.K. Crompton's excellent remarks.

First, indeed, although the quality of asthma care was better in patients supervised by specialists, it was far from being optimal. This point was mentioned in the discussion of our article: "Though improved outcomes were observed regarding asthma management in patients exclusively supervised by specialists, asthma control and patients' quality of life could also be improved in this group." 1.

Secondly, we also agree that the quality of use of inhaler devices by patients is a major determinant of asthma control. Unfortunately, for practical reasons, we could not study this issue in our survey. Indeed, studying patients' ability to use their inhaled devices would have required, for example, having dummy devices for each inhaled controller therapy and providing pharmacies with sufficient numbers of these devices, besides active training in the use of devices, which was beyond the objective of the study. Also, to our knowledge, our effort was a "première" in France owing to its active involvement of community pharmacists in the assessment of quality of care. Additional questions of interest, such as the use of inhalers, will be performed in a later phase.

We thank G.K. Crompton for his remarks and suggestions.

REFERENCES

  1. Laforest L, Van Ganse E, Devouassoux G, et al. Management of asthma in patients supervised by primary care physicians or by specialists. Eur Respir J 2006;27:42–50.[Abstract/Free Full Text]




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