title: Asthma management in a public referral center in Porto Alegre in comparison with the guidelines established in the III Brazilian Consensus on Asthma Management.
abstract: OBJECTIVE
  To determine whether the guidelines put forth in the III Brazilian Consensus on Asthma Management are being applied in a population of asthma patients treated at a public hospital that is a referral center for asthma in the city of Porto Alegre, Brazil.
  
  
  METHODS
  All adult asthma patients who began their treatment between 1999 and 2002 were evaluated. The treatment given was classified as consistent or inconsistent with the Consensus guidelines. The clinical features of asthma and the frequency of treatment provided by a specialist were compared between the two groups (those receiving guideline-consistent treatment and those receiving guideline-inconsistent treatment).
  
  
  RESULTS
  The charts of 357 patients were evaluated. The study sample consisted of 106 males (29.9%) and 251 females (70.3%). The mean age was 41 years, and 33 (9.2%) of the patients were smokers. The treatment was considered inconsistent with the Consensus guidelines in 246 cases (70%). Of those 246, 174 (71%) had presented persistent asthma and were not treated with an inhaled corticosteroid. Normal forced expiratory volume in one second, being from 12 to 18 years of age, and having intermittent asthma were more frequently observed among the patients receiving guideline-consistent treatment (p < 0.01). No correlations were found between guideline-inconsistent treatment and being treated by a pulmonologist, severity of persistent asthma or number of emergency room visits.
  
  
  CONCLUSIONS
  Most of the asthma patients treated at the public referral center in Porto Alegre did not receive treatment that was consistent with the Consensus guidelines. Undertreatment with inhaled corticosteroids was the principal source of that inconsistency.
authors.affiliation: Internal Medicine Department of the Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil. waldomattos@uol.com.br
authors.forename: Waldo
authors.initials: W
authors.lastname: Mattos
authors.forename: Luciano Bauer
authors.initials: LB
authors.lastname: Grohs
authors.forename: Fabíola
authors.initials: F
authors.lastname: Roque
authors.forename: Maurício
authors.initials: M
authors.lastname: Ferreira
authors.forename: Gabriela
authors.initials: G
authors.lastname: Mânica
authors.forename: Ernesto
authors.initials: E
authors.lastname: Soares
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000188:drug therapy*; D001938:Brazil; D002648:Child; D032921:Consensus; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic / Q000592:standards; D017150:Public Sector; D012189:Retrospective Studies; D012720:Severity of Illness Index