Asthma management: how effective is it in the community?
BACKGROUND
The National Asthma Campaign (NAC) was launched in Australia in 1989 with the major objective of improving asthma management through the implementation of a six-step asthma management plan.


OBJECTIVE
The objective of the present study was to analyse the management of asthma in a cohort of adults with self-reported asthma 10 years after the commencement of the NAC.


METHODS
The subjects were participants in the laboratory phase of a cross-sectional epidemiological study conducted in Melbourne in 1999-2000. Participants completed the detailed European Community Respiratory Health Survey, which included specific questions about their asthma management. Participants were included in this analysis if they had a positive response to the question 'Have you ever had asthma?'. This resulted in a total of 435 subjects.


RESULTS
Of the subjects with self-reported asthma, over half of the participants reported that a doctor had ever measured their breathing (52.9%). However, only 10.1% of participants reported that they owned a peakflow meter (PFM) and only 13.3% reported that they had ever been given a written action plan. In comparison with data reported from 1993, doctor measurement of lung function has decreased significantly (P < 0.000 1), as has PFM ownership (P < 0.0001) and, importantly, possession of a written action plan (P = 0.0004).


CONCLUSIONS
Asthma management among adults still falls well short of NAC guidelines. The decline in some key features over recent years suggests that new management and dissemination strategies are required.
Matheson
M
M
Department of Epidemiology and Preventive Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.
Wicking
J
J
Raven
J
J
Woods
R
R
Thien
F
F
Abramson
M
M
Walters
E H
EH
D000328:Adult; D001249:Asthma / Q000628:therapy*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'