Quality of asthma care: Western Cape Province, South Africa

dc.contributor.authorMash, Bob
dc.contributor.authorRhode, Hilary
dc.contributor.authorPather, Michael
dc.contributor.authorAinslie, Gillian
dc.contributor.authorIrusen, Elvis
dc.contributor.authorBheekie, Angeni
dc.contributor.authorMayers, Pat
dc.date.accessioned2019-03-11T13:56:44Z
dc.date.available2019-03-11T13:56:44Z
dc.date.issued2009
dc.date.updated2019-03-11T13:50:28Z
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.identifierhttp://dx.doi.org/10.7196/SAMJ.3177
dc.identifier.apacitationMash, B., Rhode, H., Pather, M., Ainslie, G., Irusen, E., Bheekie, A., & Mayers, P. (2009). Quality of asthma care: Western Cape Province, South Africa. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/29917en_ZA
dc.identifier.chicagocitationMash, Bob, Hilary Rhode, Michael Pather, Gillian Ainslie, Elvis Irusen, Angeni Bheekie, and Pat Mayers "Quality of asthma care: Western Cape Province, South Africa." <i>South African Medical Journal</i> (2009) http://hdl.handle.net/11427/29917en_ZA
dc.identifier.citationMash, B., Rhode, H., Pather, M., Ainslie, G., Irusen, E., Bheekie, A., & Mayers, P. (2009). Quality of asthma care: Western Cape Province, South Africa. South African Medical Journal, 99(12), 892-896.
dc.identifier.ris TY - AU - Mash, Bob AU - Rhode, Hilary AU - Pather, Michael AU - Ainslie, Gillian AU - Irusen, Elvis AU - Bheekie, Angeni AU - Mayers, Pat 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 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2009 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/11427/29917 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/29917
dc.identifier.vancouvercitationMash B, Rhode H, Pather M, Ainslie G, Irusen E, Bheekie A, et al. Quality of asthma care: Western Cape Province, South Africa. South African Medical Journal. 2009; http://hdl.handle.net/11427/29917.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Health and Rehabilitation Sciences
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.urihttp://www.samj.org.za
dc.subject.otherasthma care
dc.titleQuality of asthma care: Western Cape Province, South Africa
dc.typeJournal Article
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