Bridging the Gap Between Guidelines and Clinical Practice: An Audit of Asthma Management

Abstract

Background: To assess clinical practice in the light ofGINA guidelines and to identify and rectify areas ofweaknesses in current clinical practice so as to provideGINA guidelines described standard of care to ourpatients.Methods: In this descriptive study 50 consecutiveasthma patients were audited prospectively.Patientdemographics were recorded. Every patient underwentdetailed clinical evaluation as well as objective assessmentby spirometry.Results: The mean age was 43 years with femalepredominance (66%). Fifty eight percent had a familyhistory of asthma and 90% belonged to lower middle andlower classes. Diagnosis of asthma was made on clinicalgrounds in 90% and only 10% of patients had objectiveconfirmation of asthma by spirometry. Fifty two percent ofthe patients were on suboptimal treatment according todisease severity and only 30% had correct inhalertechnique. Only 40% were compliant with the prescribedtreatment and only 36% had good control of asthma.Conclusion: Discrepancy in the theoretical instructions(GINA guidelines) and the clinical practice was observedin our setting. Majority of patients were on sub-optimaltreatment with incorrect inhaler technique leading to poorasthma control