Prescribing for asthmatic children in primary care. Are we following guidelines?
OBJECTIVE
Guidelines for asthma management have been developed both locally and internationally. The aim of this study was to evaluate the adherence of primary care physicians in the National Guard Iskan Primary Care Center to these guidelines.


METHODS
The records of 206 asthmatic children who visited the National Guard Iskan Primary Care Center, Jeddah, Kingdom of Saudi Arabia, during the months of February 1998 through June 1998, were reviewed. The following data was extracted from them; presenting symptoms, number of visits, names of asthma medications, whether doses were documented or not and number of times antitussives were prescribed.


RESULTS
The most common presenting complaint was cough followed by wheeze and shortness of breath (mean SD, 14 13.8, 8.8 10.3 and 4.4 5.8). Oral salbutamol was the most frequently prescribed medication. The doses of asthma medications were not documented in 37.3% of cases. Preventive therapy was prescribed to 35.4% of children and emergency steroids were prescribed to 30.6% of children. The mean age of asthmatic children receiving inhaled medications was significantly higher than those other forms of therapy (p<0.00001). Antitussives were prescribed 2,536 times (mean 12.3).


CONCLUSIONS
Prescribing for asthmatic children did not conform to national guidelines for treatment of asthma. These findings suggest that ways need to be found: (i) to increase the use of current asthma management guidelines by practitioners; (ii) to improve documentation of prescribed medications and their dosage and; (iii) to improve education of parents in home management measures.
Dashash
Noha A
NA
Department of Family Medicine, Joint Program of Family and Community Medicine, King Abdul-Aziz University, Jeddah, Kingdom of Saudi Arabia. drnohadashash@yahoo.com
Mukhtar
Saud H
SH
D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000420:Albuterol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D008297:Male; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D000068299:Salmeterol Xinafoate; D012529:Saudi Arabia; D013806:Theophylline / Q000627:therapeutic use
D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D000068299:Salmeterol Xinafoate; D013806:Theophylline; D000420:Albuterol