[Monitoring of asthma outpatients after adapting treatment to meet international guidelines].
OBJECTIVE
Poor control of asthma treated in outpatient settings has been demonstrated. The aim of this study was to perform a short intervention, readily replicable in everyday practice, to try to improve control of the disease.


METHODS
Two primary health care clinics made appointments with asthma patients to administer a questionnaire and adapt their treatment to the guidelines of the Global Initiative for Asthma. Patients also received an explanation of the disease lasting not more than 5 minutes. The protocol was repeated at a second visit 4 months later. Health care parameters were compared with those from the previous visit.


RESULTS
The characteristics of the 180 patients were as follows: 70% were women, 17% were smokers, 8% were illiterate, 46% had only primary education, 45% were in contact with cleaning products, and 63% had extrinsic asthma. The asthma severity was as follows: mild in 73%, moderate in 23%, and severe in 4%. Twenty-two percent had received previous explanations of the disease, 50% had a written treatment plan, 14% had a plan for exacerbations, and 54% were taking inhaled corticosteroids. The second appointment was kept by 110 (61%) of the patients, who showed differences with respect to the previous visit 4 months earlier in the percentage taking inhaled corticosteroids (78%, P< .001), the number of visits to the physician (P< .01), visits to the physician due to exacerbations (P< .001), emergency visits to the outpatient clinic (P< .002), and disease severity (P< .02).


CONCLUSIONS
This minimal clinical intervention reduced the need for visits to health care centers and improved the control of asthma symptoms.
Morell
Ferran
F
Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Centre d'Assistència Primària San Rafael (SAP Muntanya), Barcelona, España. fmorell@vhebron.net
Genover
Teresa
T
Reyes
Leonardo
L
Benaque
Esther
E
Roger
Alex
A
Ferrer
Jaume
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001071:Appointments and Schedules; D001249:Asthma / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D002648:Child; D003902:Detergents / Q000009:adverse effects; D004522:Educational Status; D004781:Environmental Exposure; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D010045:Outpatients; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013689:Telephone
D018927:Anti-Asthmatic Agents; D003902:Detergents