Quality of asthma care: Western Cape Province, South Africa

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dc.date.accessioned2021-10-08T07:17:57Z
dc.date.available2021-10-08T07:17:57Z
dc.date.issued2009
dc.description.abstractAsthma is the eighth leading contributor to the burden of disease in South Africa, but has received less attention than other chronic diseases. The Asthma Guidelines Implementation Project (AGIP) was established to improve the impact of the South African guidelines for chronic asthma in adults and adolescents in the Western Cape. One strategy was an audit tool to assist with assessing and improving the quality of care. Methods. The audit of asthma care targeted all primary care facilities that managed adult patients with chronic asthma within all six districts of the Western Cape province. The usual steps in the quality improvement cycle were followed. Results. Data were obtained from 957 patients from 46 primary care facilities. Only 80% of patients had a consistent diagnosis of asthma, 11.5% of visits assessed control and 23.2% recorded a peak expiratory flow (PEF), 14% of patients had their inhaler technique assessed and 11.2% were given a self-management plan; 81% of medication was in stock, and the controller/reliever dispensing ratio was 0.6. Only 31.5% of patients were well controlled, 16.3% of all visits were for exacerbations, and 17.6% of all patients had been hospitalised in the previous year. Conclusion. The availability of medication and prescription of inhaled steroids is reasonable, yet control is poor. Health workers do not adequately distinguish asthma from chronic obstructive pulmonary disease, do not assess control by questions or PEF, do not adequately demonstrate or assess the inhaler technique, and have no systematic approach to or resources for patient education. Ten recommendations are made to improve asthma care.
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AB - Asthma is the eighth leading contributor to the burden of disease in South Africa, but has received less attention than other chronic diseases. The Asthma Guidelines Implementation Project (AGIP) was established to improve the impact of the South African guidelines for chronic asthma in adults and adolescents in the Western Cape. One strategy was an audit tool to assist with assessing and improving the quality of care. Methods. The audit of asthma care targeted all primary care facilities that managed adult patients with chronic asthma within all six districts of the Western Cape province. The usual steps in the quality improvement cycle were followed. Results. Data were obtained from 957 patients from 46 primary care facilities. Only 80% of patients had a consistent diagnosis of asthma, 11.5% of visits assessed control and 23.2% recorded a peak expiratory flow (PEF), 14% of patients had their inhaler technique assessed and 11.2% were given a self-management plan; 81% of medication was in stock, and the controller/reliever dispensing ratio was 0.6. Only 31.5% of patients were well controlled, 16.3% of all visits were for exacerbations, and 17.6% of all patients had been hospitalised in the previous year. Conclusion. The availability of medication and prescription of inhaled steroids is reasonable, yet control is poor. Health workers do not adequately distinguish asthma from chronic obstructive pulmonary disease, do not assess control by questions or PEF, do not adequately demonstrate or assess the inhaler technique, and have no systematic approach to or resources for patient education. Ten recommendations are made to improve asthma care. DA - 2009 DB - OpenUCT DP - University of Cape Town IS - 12 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2009 SM - 0038-2469 T1 - Quality of asthma care: Western Cape Province, South Africa TI - Quality of asthma care: Western Cape Province, South Africa UR - http://hdl.handle.net/11427/34869 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34869
dc.language.isoeng
dc.publisher.departmentUCT Lung Institute
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue12
dc.source.journalvolume99
dc.source.pagination892 - 896
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.3177
dc.subject.otherTropical medicine
dc.subject.otherQuality
dc.subject.otherAsthma
dc.subject.otherWestern Cape
dc.subject.otherLung disease
dc.subject.otherBronchus disease
dc.subject.otherObstructive pulmonary disease
dc.subject.otherRespiratory disease
dc.subject.otherAfrica
dc.subject.otherSouth Africa
dc.subject.otherMédecine tropicale
dc.subject.otherQualité
dc.subject.otherAsthme
dc.subject.otherLe Cap-Occidental
dc.subject.otherPathologie des poumons
dc.subject.otherPathologie des bronches
dc.subject.otherBronchopneumopathie obstructive
dc.subject.otherPathologie de l'appareil respiratoire
dc.subject.otherAfrique
dc.subject.otherAfrique du Sud
dc.subject.otherMedicina tropical
dc.subject.otherCalidad
dc.subject.otherAsma
dc.subject.otherCabo Occidental
dc.subject.otherPulmón patología
dc.titleQuality of asthma care: Western Cape Province, South Africa
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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