Mohammad Mohsin Rana, Yosuf Hassan, Ghazanfar Ali Sandhu, Abedur Rehman.
Bronchial Asthma; assessment of patient`s awareness level about different aspects of their disease.
Professional Med J Jan ;11(3):285-293.

Objectives: To assess the patients level of understanding of their disease and their experience in the management offered to them. Introduction: Bronchial Asthma is a common episodic disorder of all ages. Successful management depends on active and continuous interaction between the clinician and a well-educated patient. Detailed interview of patients ware carried out on different; aspects of their experience of the management and to assess the level of understanding of their disease. This would highlight the common deficiencies in the management in our own setup. Study Design: Observational; study. Period: From January to December 2003, Setting: Al-Shifa Medical Center Faisalababd Materials & Methods: Any patient with a diagnosis of Bronchial Asthma and using MDI device was assessed for the competency of diagnosis. A specially trained nurse interviewed the eligible patients on a prescribed performa. The physician checked all the information before making a detailed clinical examination. Patients below the age of 16 or over the age of 60, seriously sick patients and COPD were excluded. Results: 192 patients were enrolled in this study. There were 112 males and 80 females. 66% incriminated allergy to something, 75% blamed upper respiratory tract infection, 54% recognized exercise as the precipitating event, 33 attributed it to emotions, only 8% recognized menses as the factor, 54% related it with environmental change or specific environment, 41 % related it with change in season or through some particular season, 68% called it dust allergy, 12.5% recognized pets and chemicals as the culprit, 8% incriminated work place environment and 16.7% could recall some specific drug as the cause of their attack of asthma. One patient could connect more than one stimulus to his or her attack. Only 52%, 44% and 32% of patients knew the mode of action and the difference between the three most commonly used drugs i.e. aminophyllines and steroids respectively 92% did not have a rescue prescription for their acute severe attack our had any concept of it. 79% gauged the severity of their attack of acute severe Asthma on the basis of perceived severity of symptoms and 58% on frequency of symptoms. Only 29% could recognize bouts of cough as a symptom of Asthma. Only 8% of patients were objectively tested by measuring PFR at the clinics of their doctors and only half of them were doing it at home. Conclusion: Well-educated patients can do a lot in modifying their treatment. This study speaks loudly of the inadequacies in our management. More emphasis on different aspects of patient education is the only way to improve our standard of Asthma care.

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