title: The burden of adult asthma in a high GDP per capita country: the QASMA study.
abstract: BACKGROUND
  Asthma is a major health problem worldwide. Suboptimal asthma care and poor asthma control are common even in developed countries. Qatar has the highest gross domestic product per capita in the world and high per capita health expenditure. No prior study has assessed the burden of adult asthma in this country.
  
  
  OBJECTIVE
  To assess asthma control, patients' level of education about asthma, and level of asthma care in a country with the highest gross domestic product per capita in the world.
  
  
  METHODS
  A face-to-face, cross-sectional study of 520 adults with physician-diagnosed asthma conducted in various health care facilities in Qatar.
  
  
  RESULTS
  Thirty-three percent, 41%, and 26% of patients had uncontrolled, controlled, and partly controlled asthma, respectively. Only 4.9% of patients had previously received a written asthma management plan, 3.5% had a flow meter at home, and 37.2% had a spirometry performed in the previous 5 years. In addition, 42.9% misunderstood the role of reliever and controller medications. Inhaler technique was incorrect in 47% of these patients. There was a significant association between the type of physician practice and level of asthma control, with worst control being at the general practice level. Moreover, 57.3% of patients had at least 1 asthma-related visit to the emergency department in 1 year and 18.7% had more than 3 visits.
  
  
  CONCLUSIONS
  The very high gross domestic product per capita in Qatar and the high health expenditure per capita do not seem to have led to better asthma care and control. A comprehensive national asthma service improvement program is much needed.
authors.affiliation: Department of Medicine, Pulmonary Section, Hamad General Hospital and Weill-Cornell Medical College, Doha, Qatar. Electronic address: wibrahim@hmc.org.qa.
authors.forename: Wanis H
authors.initials: WH
authors.lastname: Ibrahim
authors.affiliation: Department of Medicine, Hamad General Hospital, Doha, Qatar.
authors.forename: Noor N
authors.initials: NN
authors.lastname: Suleiman
authors.affiliation: Department of Medicine, Hamad General Hospital, Doha, Qatar.
authors.forename: Fathi
authors.initials: F
authors.lastname: El-Allus
authors.affiliation: Department of Public Health, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Jamal
authors.initials: J
authors.lastname: Suleiman
authors.affiliation: Department of Medicine, Hamad General Hospital, Doha, Qatar.
authors.forename: Abdurrahmaan A
authors.initials: AA
authors.lastname: Elbuzidi
authors.affiliation: Department of Medicine, Hamad General Hospital, Doha, Qatar.
authors.forename: Mylai D
authors.initials: MD
authors.lastname: Guerrero
authors.affiliation: Department of Emergency Medicine, Hamad General Hospital, Doha, Qatar.
authors.forename: Aldwin N
authors.initials: AN
authors.lastname: Guerrero
authors.affiliation: Department of Medicine, Hamad General Hospital, Doha, Qatar.
authors.forename: Abdelrauof
authors.initials: A
authors.lastname: Akkari
authors.affiliation: Department of Medicine, Hamad General Hospital, Doha, Qatar.
authors.forename: Hanfa
authors.initials: H
authors.lastname: Karim
authors.affiliation: Department of Medicine, Hamad General Hospital, Doha, Qatar.
authors.forename: Samah A
authors.initials: SA
authors.lastname: Awouda
authors.affiliation: Department of Medicine, Hamad General Hospital, Doha, Qatar.
authors.forename: Salma
authors.initials: S
authors.lastname: Suliman
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology* / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D006078:Government Programs; D059066:Gross Domestic Product; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D015995:Prevalence; D011780:Qatar; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D055815:Young Adult