title: Management of asthma in patients supervised by primary care physicians or by specialists.
abstract: French asthma patients may be supervised by general practitioners (GPs) and/or specialists. Therefore, this study examined asthma management in patients exclusively supervised by specialists (SPE), GPs, (GP) and both (GP+SPE group), and compared the findings. Asthma patients were consecutively recruited in 348 pharmacies. Each patient completed a questionnaire providing data on personal characteristics, asthma management, perception of disease and asthma supervision. Asthma control was measured using the Asthma Control Test. Questionnaires were linked to computerised records of medications which had been dispensed before inclusion in the study. From the 1,256 patients (mean age = 36.1 yrs, 54.3% females), 11.4, 36.6, and 52.0% were placed in the SPE, GP, and GP+SPE groups, respectively. During the previous 4 weeks, most patients in the SPE group were properly controlled (52.2 versus 26.4 and 21.5% in GP and GP+SPE groups, respectively). The SPE group made more use of fixed combinations of long-acting beta agonist and inhaled corticosteroid, while receiving less short-acting beta agonists, antitussives and antibiotics. Striking differences in symptoms and asthma management were observed according to the type of asthma supervision. The current results strongly support the need to improve the management of asthma in primary care, and the coordination of care between general practitioners and specialists.
authors.affiliation: Unité de Pharmacoépidémiologie, Centre Hospitalier Lyon-Sud, France.
authors.forename: L
authors.initials: L
authors.lastname: Laforest
authors.forename: E
authors.initials: E
authors.lastname: Van Ganse
authors.forename: G
authors.initials: G
authors.lastname: Devouassoux
authors.forename: S
authors.initials: S
authors.lastname: Chretin
authors.forename: L
authors.initials: L
authors.lastname: Osman
authors.forename: G
authors.initials: G
authors.lastname: Bauguil
authors.forename: Y
authors.initials: Y
authors.lastname: Pacheco
authors.forename: G
authors.initials: G
authors.lastname: Chamba
mesh_terms: D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008511:Medicine; D010821:Physicians, Family; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D013038:Specialization; D011795:Surveys and Questionnaires
chemical_list: D018927:Anti-Asthmatic Agents