Factors affecting compliance and control of asthma in patients attending the Respiratory Outpatient Department, Chris Hani Baragwanath Academic Hospital

Abstract

Background. ere is a sense among respiratory physicians that asthma is poorly controlled in public sector hospitals, possibly due to poor adherence and lack of knowledge regarding inhaler technique. Objective. To describe the status of asthma control in patients attending the Respiratory Outpatient Department at Chris Hani Baragwanath Academic Hospital. Methods. A retrospective record review was conducted on outpatient les of asthmatics known to the Respiratory Department. Data obtained included demographics, level of control and number of admissions and exacerbations. Results. A total of 519 patient les were reviewed, 74.2% of whom were female. e mean (standard deviation) age was 47 (16.5) years. We found 47.2% of patients were controlled, 30.4% partially controlled and 22.4% uncontrolled. Most patients (88%) had no admissions in the previous year. About 60% had not experienced exacerbations in the previous year. ere were signicant dierences between the three groups for number of exacerbations, both per year and per lifetime, and type of steroid prescribed. For a number of signicant areas, such as forced expiratory volume in one second (FEV1%) predicted and competency of inhaler technique, a large proportion of the data (>30%) had not been documented by the attending doctor in the patient les. Conclusion. In this population of mostly middle-aged female asthmatics, less than half the patients were well-controlled despite very few admissions or exacerbations in the previous year. Documentation by clinicians of aspects indicative of asthma control was generally poor, and better documentation should be encouraged in order to improve knowledge and highlight awareness of best practice in the management of asthma.