title: University and public health system partnership: A real-life intervention to improve asthma management.
abstract: OBJECTIVE
  Asthma is under-diagnosed in many parts of the world. We aimed to assess the outcome of a capacitating program on asthma for non-specialist physicians and other healthcare professionals working in the public system in Ribeirão Preto, Brazil.
  
  
  METHODS
  A group of 16 asthma specialists developed a one-year capacitating program in 11 healthcare clinics in the Northern District of the city, which included lectures on asthma, training on inhalation device use and spirometry, and development of an asthma management protocol. Researchers visited one health unit 2-4 times monthly, working with doctors on patients' care, discussing cases, and delivering lectures. Asthma education was also directed to the general population, focusing on recognition of signs and symptoms and long-term treatment, including production of educational videos available on YouTube. Outcome measures were the records of doctors' prescriptions of individual asthma medications pre- and post-intervention.
  
  
  RESULTS
  Prior to the program, 3205 units of inhaled albuterol and 2876 units of inhaled beclomethasone were delivered by the Northern District pharmacy. After the one-year program, there was increase to 4850 units (51.3%) for inhaled albuterol and 3526 units (22.6%) for inhaled beclomethasone. The albuterol increase followed the recommendation given to the non-specialist doctors by the asthma experts, that every patient with asthma should have inhaled albuterol as a rescue medication, by protocol. No increase was observed in other districts where no capacitating program was conducted.
  
  
  CONCLUSIONS
  A systematic capacitating program was successful in changing asthma prescription profiles among non-specialist doctors, with increased delivery of inhaled albuterol and beclomethasone.
authors.affiliation: a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Janaina
authors.initials: J
authors.lastname: Melo
authors.affiliation: a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Moreno
authors.affiliation: b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Virginia
authors.initials: V
authors.lastname: Ferriani
authors.affiliation: c Department of Medicine , University of Ribeirão Preto UNAERP , Ribeirão Preto , Brazil.
authors.forename: Ana Carla
authors.initials: AC
authors.lastname: Araujo
authors.affiliation: a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Elcio
authors.initials: E
authors.lastname: Vianna
authors.affiliation: a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Borges
authors.affiliation: b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Pérsio
authors.initials: P
authors.lastname: Roxo
authors.affiliation: b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Gonçalves
authors.affiliation: d Department of Social Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Luane
authors.initials: L
authors.lastname: Mello
authors.affiliation: e Department of Pediatrics , Barão de Mauá University Center , Ribeirão Preto , Brazil.
authors.forename: Rosa
authors.initials: R
authors.lastname: Parreira
authors.affiliation: b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Jorgete
authors.initials: J
authors.lastname: Silva
authors.affiliation: b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Patricia
authors.initials: P
authors.lastname: Stefanelli
authors.affiliation: b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Larissa
authors.initials: L
authors.lastname: Panazolo
authors.affiliation: a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Andrea
authors.initials: A
authors.lastname: Cetlin
authors.affiliation: a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Luana
authors.initials: L
authors.lastname: Queiroz
authors.affiliation: a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Rosângela
authors.initials: R
authors.lastname: Araujo
authors.affiliation: a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Marina
authors.initials: M
authors.lastname: Dias
authors.affiliation: b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: Davi
authors.initials: D
authors.lastname: Aragon
authors.affiliation: f Health Secretariat of Municipal Government of the City of Ribeirão Preto , Ribeirão Preto , Brazil.
authors.forename: Nélio
authors.initials: N
authors.lastname: Domingos
authors.affiliation: a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.
authors.forename: L Karla
authors.initials: LK
authors.lastname: Arruda
mesh_terms: D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy / Q000628:therapy*; D001938:Brazil; D001993:Bronchodilator Agents / Q000008:administration & dosage; D057191:Capacity Building / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D019468:Disease Management; D004363:Drug Utilization / Q000706:statistics & numerical data; D006266:Health Education / Q000458:organization & administration; D006801:Humans; D007373:Interinstitutional Relations; D011635:Public Health Administration; D014495:Universities / Q000458:organization & administration*
chemical_list: D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents
keywords: Asthma; diagnosis; professional education; regional medical programs; wheezing