Objectives: Poorly controlled asthma imposes a considerable burden and is a
serious public health problem in the developing world. A key challenge for
healthcare professionals is to help patients to engage in self-management
behaviours with optimal adherence to appropriate treatment. The aim of the
present study was to investigate the pattern of self-management in asthmatic
patients enrolled as out-patients in a tertiary care referral public chest
hospital, in Delhi, India.
Methods: The study population was adult asthma patients (n=200) visiting the
emergency room (December 2008-December 2009) of a chest hospital for asthma
exacerbation. The data was collected through a questionnaire regarding the
self-management of asthma.
Results: Enrolled patients (64.0% female) were registered as asthma
out-patients in the study hospital for a mean of 5.4±4.4 years. Patients
visiting the emergency room (ER) and having an unscheduled visit to doctor at
least twice in the previous 12 months were 86.5% and 91.0%. Patients were
classified according to the disease severity as having intermittent (17.0%) or
persistent (83.0%) asthma. Not all patients had metered dose inhalers at home.
Only 2.0% of patients were prescribed peak flow meters and were keeping a diary
of their readings. With one exception, patients did not have written action
plans for treatment provided by doctor or health facility. No statistical
difference was found in the pattern of self-management of patients having
persistent or intermittent asthma.
Conclusions: Findings revealed poor self-management of asthma and poor
communication from doctors regarding self-management to the patients. Suitable
actions and interventions are needed by health professionals to implement
patient self-management asthma programme for optimum asthma control.