title: [Cost and management of asthma attacks treated in primary care (COAX Study)].
abstract: OBJECTIVE
  To estimate the cost and characterize the management of asthma attacks in primary care.
  
  
  METHODS
  Prospective, observational study of 1 year's duration. Setting. 10 physician's offices at 9 primary care centers located in 5 provinces (Asturias, Barcelona, Cadiz, Madrid, and Valencia) of Spain.
  
  
  METHODS
  10 family physicians who saw 133 consecutive patients with an asthma attack.
  
  
  METHODS
  Prospective, observational study; no intervention was used. Direct and indirect costs arising from asthma attacks were calculated. Episodes were treated according to the physicians' habitually used procedures; the study protocol did not specify any predetermined intervention.
  
  
  RESULTS
  The attacks were classified as mild in 43.6% of the cases, moderately severe in 43.6%, and severe in 12.8%. Of all severe attacks, 17.2% occurred in patients with intermittent asthma. The more severe the attack, the less preventive treatment patients had received previously. The mean cost of asthma attacks was 166.7 (95% CI, 146.5-192.3); 80% (132.4) (95% CI, 122.7-143.8) were direct costs and 20% (34.3) (95% CI, 17-56.2) were indirect costs. The most economical management option was to change treatment, perform diagnostic tests and have the patient attend 2 follow-up appointments with the physician.
  
  
  CONCLUSIONS
  Mean cost of each asthma attack treated in primary care was 166.7 (95% CI, 146.5-192.3), of which 80% were direct costs and 20% indirect costs.
authors.affiliation: CS Francia I. Fuenlabrada. Madrid. España.
authors.forename: J
authors.initials: J
authors.lastname: Molina París
authors.forename: G
authors.initials: G
authors.lastname: Lumbreras García
authors.forename: E
authors.initials: E
authors.lastname: Calvo Corbella
authors.forename: K
authors.initials: K
authors.lastname: Naberan Toña
authors.forename: M A
authors.initials: MA
authors.lastname: Lobo Alvarez
mesh_terms: D018927:Anti-Asthmatic Agents / Q000191:economics* / Q000627:therapeutic use; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics; D011446:Prospective Studies; D013224:Status Asthmaticus / Q000188:drug therapy / Q000191:economics*
chemical_list: D018927:Anti-Asthmatic Agents