Care of asthmatic patients in primary health care centers

This is a retrospective study of the medical records of asthmatics using a predesigned form. The purpose of the study is to define the number of patients registered as asthmatics at a random selection of primary health care centers (PHCCs) in Riyadh and to describe sociodemographic, clinical and management characteristics of this population of asthmatics with a view to recommending changes which might improve the care for asthma patients. Items of inquiry included demographic data, clinical features, management and health center profiles of the patients. Patients from 60 primary health care centers were studied. There were 2081 asthmatic patients found in the studied PHCCs (out of 255,145 surveryed), giving a rate of 0.8%. Out of all the patients, 32.8% were children 16 years of age or below and 23.7% were above 45 years of age. The male to female ratio was 1.2:1. The presenting symptoms were cough in 82.3% and shortness of breath in 64.8%. Atopic disorders such as eczema and allergic rhinitis were recorded in 27.7%. PHCCs diagnosed 61.9% depending on history acid clinical examination. Out of all patients, 10.6% did not utilize a PHCC, 29.5% were referred to a specialist and 8.7% needed admission to the hospital one or more times. Oral salbutamol was used in more than 45.7% of the patients. The number of registered bronchial asthma patients at the PHCCs was very low. Even when registered, asthmatic patients are getting suboptimal care. The present study provides a basis for intervention and a baseline from which to measure the benefits of intervention. It also provides the strongest possible support for the Ministry of Health, who recently initiated a National Asthma Program.