BRONCHIAL ASTHMA

ASSESSMENT OF PATIENT’S AWARENESS LEVEL ABOUT DIFFERENT ASPECTS OF THEIR DISEASE

Abstract

Objectives: To assess the patients level of understanding
of their disease and their experience in the management offered to them. Introduction: Bronchial Asthma is
a common episodic disorder of all ages. Successful management depends on active and continuous interaction
between the clinician and a well-educated patient. Detailed interview of patients ware carried out on different
aspects of their experience of the management and to assess the level of understanding of their disease. This
would highlight the common deficiencies in the management in our own setup. Study Design: Observational
study. Period: From January to December 2003, Setting: Al-Shifa Medical Center Faisalababd Materials &
Methods: Any patient with a diagnosis of Bronchial Asthma and using MDI device was assessed for the
competency of diagnosis. A specially trained nurse interviewed the eligible patients on a prescribed performa.
The physician checked all the information before making a detailed clinical examination. Patients below the age
of 16 or over the age of 60, seriously sick patients and COPD were excluded. Results: 192 patients were
enrolled in this study. There were 112 males and 80 females. 66% incriminated allergy to something, 75%
blamed upper respiratory tract infection, 54% recognized exercise as the precipitating event, 33 attributed it to
emotions, only 8% recognized menses as the factor, 54% related it with environmental change or specific
environment, 41% related it with change in season or through some particular season, 68% called it dust allergy,
12.5% recognized pets and chemicals as the culprit, 8% incriminated work place environment and 16.7% could
recall some specific drug as the cause of their attack of asthma. One patient could connect more than one
stimulus to his or her attack. Only 52%, 44% and 32% of patients knew the mode of action and the difference
between the three most commonly used drugs i.e. aminophyllines and steroids respectively.92% did not have
a rescue prescription for their acute severe attack or had any concept of it. 79% gauged the severity of their
attack of acute severe Asthma on the basis of perceived severity of symptoms and 58% on frequency of
symptoms. Only 29% could recognize bouts of cough as a symptom of Asthma. Only 8% of patients were
objectively tested by measuring PFR at the clinics of their doctors and only half of them were doing it at home.
Conclusion: Well-educated patients can do a lot in modifying their treatment. This study speaks loudly of the
inadequacies in our management. More emphasis on different aspects of patient education is the only way to
improve our standard of Asthma care.