Unmet needs in asthma treatment in a resource-limited setting: findings from the survey of adult asthma patients and their physicians in Nigeria.
BACKGROUND
The prevalence of asthma in our society is rising and there is need for better understanding of the asthma patients' perception and treatment practice of physicians. The study was aimed at determining asthma attitudes and treatment practices among adult physicians and patients in Nigeria, with the goal of identifying barriers to optimal management.


METHODS
To assess asthma attitudes, treatment practices and limitations among adult physicians and patients in Nigeria, a questionnaire survey was conducted among 150 patients and 70 physicians.


RESULTS
Majority (66.7%) of the patients reported their asthma as moderate to severe, 42.7% had emergency room visit and 32% had admission due to asthma in the previous 12 months. Physicians and patients perceptions significantly differed in the time devoted to educational issues (31.4% vs.18.7%) and its contents: individual management plan (64.3% vs.33.3%), correct inhaler technique (84.0% vs.71.0%), medication side effects (80.0% vs.60.0%) and compliance 100% of time (5.7% vs. 18.7%). Patients reported that non-compliance with medication causes increased symptoms (67.0%), exacerbations (60.0%), bronchodilator use (56.0%), urgent physician visit (52.0%) and hospitalizations /ER visits (38.7%). Asthma medication in patients caused short term (10.7%) and long term side effects (20.0%). Due to side effects, 28.0% skipped and stopped their medications. Most physicians (85.7%) and patients (56.0%) agreed on the need for new medication options. The need for new medication in patients was strongly related to asthma severity, limitation of activities, side effects, cost and lack of satisfaction with current medication. With the exception of pulmonologists, physicians did not readily prescribe ICS and their prescriptions were not in line with treatment guidelines.


CONCLUSIONS
This study has highlighted the gaps and barriers to asthma treatment which need to be addressed to improve the quality of care in Nigeria.
AffiliationDepartment of Medicine, University of Ilorin Teaching Hospital, Nigeria.
Olufemi Olumuyiwa
OO
Desalu
Department of Medicine University of Nigeria Teaching Hospital Ituku Ozalla Enugu, Nigeria.
Cajetan Chigozie
CC
Onyedum
Department of Medicine Ekiti State University Teaching Hospital Ado-Ekiti, Nigeria.
Adekunle Olatayo
AO
Adeoti
Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria.
Obianuju Beatrice
OB
Ozoh
Department of Pharmacology, Ekiti State University Teaching Hospital Ado-Ekiti, Nigeria.
Joseph Olusesan
JO
Fadare
Department of Medicine, Federal Medical Centre Yola, Nigeria.
Fatai Kunle
FK
Salawu
Department of Medicine, Federal Medical Centre Yola, Nigeria.
Ali
A
Danburam
AffiliationDepartment of Medicine, University of Ilorin Teaching Hospital, Nigeria.
Ademola Emmanuel
AE
Fawibe
Department of Medicine, Obafemi Awolowo University Teaching Hospital Ile-Ife, Nigeria.
Olanisun Olufemi
OO
Adewole
D000328:Adult; D001249:Asthma / Q000191:economics / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006295:Health Resources / Q000191:economics / Q000600:supply & distribution*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010465:Perception; D010817:Physician-Patient Relations; D011203:Poverty; D011364:Professional Practice / Q000191:economics / Q000706:statistics & numerical data*; D055815:Young Adult
Asthma; barriers; communication; education; side effects; treatment compliance; treatment practices