[Care of children and adolescents with asthma by primary care physicians: current situation and proposals for improvement].
BACKGROUND
To provide good asthma care to children and adolescents the following conditions are required: well-trained health professionals with the structure and resources necessary to perform their work efficiently, and client satisfaction as a measure of compliance and self-management. The aims of this study were to determine the current situation of asthma management by primary care pediatricians and to promote improvement of the healthcare and quality of life of these children and their families.


METHODS
We performed a descriptive study. A questionnaire was completed by primary care pediatricians attending asthma courses given by the Respiratory Team of the Spanish Association of Primary Care Pediatrics in 2001.


RESULTS
Three hundred twenty-three questionnaires were completed. The mean age of the pediatricians was 42 years and 70.6 % were women. A total of 7.4 % referred all patients to the pediatric pneumologist and 21.3 % referred all patients to the pediatric allergy clinic; 61.9 % referred only patients with moderate-severe persistent asthma. Concerning items registered in medical records, 32.5 % recorded a codified asthma diagnosis and 61 % included severity classification. Spirometers were available to 48.6 % and peak flow meters to 45.5 %. With regard to lung function measurement, 17.3 % performed spirometry and 33.2 % performed peak expiratory flow. Concerning asthma educational issues, 90.4 % had received education on environmental factors, 81.7 % had received training in the proper use of medication inhalers and 41.2 % had received training in written self-management plans.


CONCLUSIONS
This is the first study to present results on the current situation of asthma management by primary care pediatricians in Spain. The results show the need to improve record-keeping, facilitate the resources required for diagnosis and follow-up and prioritize education in order to achieve an optimal level of self-management by patients and their families.
Lora Espinosa
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Centro de Salud Ciudad Jardín. Málaga. España. alora@telefonica.net
D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002662:Child Health Services / Q000592:standards*; D002983:Clinical Competence / Q000592:standards; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D010372:Pediatrics / Q000193:education / Q000458:organization & administration*; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000592:standards*; D013030:Spain; D013147:Spirometry / Q000379:methods; D011795:Surveys and Questionnaires