Are there differences between specialist and primary care in asthma treatment?

Abstract

Objective. To determine whether differences exist in the monitoring, diagnosis and treatment of asthmatic patients between family doctors (FD) and pneumology specialists (PD).

Design. A descriptive crossover study, performed through an interview with the patients and a medical exploration.

Setting. Six Health Centres.

Patients. 195 asthmatic patients between 14 and 65, chosen by simple random sampling from among all those registered by computer in the SICAP.

Measurements and main results. Each patient answered a structured interview and had a spirometry test. Which doctor usually monitored their illness, social and demographic data, morbidity parameters, treatment prescribed and their compliance with it, were all determined. 66% of patients were under their FD. No differences were found in the clinical characteristics of patients treated by their FD against those treated by their PD..

Conclusions. Most adult asthmatics are under the care of FDs; however, these appear to under-treat to a considerable degree, especially respecting the use of inhaled corticosteroids. It must be emphasised strongly that Asthma is an inflammatory disease; and FDs must become better informed of the directives of the international consensus on asthma.