PURPOSE: There are several internationally accepted guidelines for the management of asthma, we examined the utilization of these guidelines in the management of asthmatics as well as the use of inhaler devices among the asthmatics presenting for specialist assessment and treatment at Lagos, Nigeria.
METHODS: 106 consecutive patients with physician diagnosed asthma referred on account of poor control for specialist review participated in the study between April 2006 and March 2007. The setting was the chest clinic of the Lagos state university teaching hospital , Ikeja. Lagos Nigeria.The patients between age 13 and 64 years were interviewed about asthma control using previous hospitalization, frequency of nighttime symptoms, and frequency of emergency visits. Their knowledge of medications was assessed. Inhaler techniques were observed.
RESULTS: 52 (49.1%) had previous hospitalization for asthma. (50) 47.2% had weekly night time symptoms. 48 (45.3%) had exacerbations requiring treatment at the emergency room in the week preceding the interview.The meter dose inhaler was the commonest drug delivery device in use by 72 (67.9%) of the patients.32(30.2%)used a diskus. only 10 (10.6%) used nebulisers at any point.The inhaler technique was rated as Good in only 34 (47.2%) out of the 72 respondents and poor in 38 (52.8%). only 34 respondents satisfactorily performed all steps. (100) 94.3% skip their medication. Majority of the Asthmatics did not receive any Health education about their medical condition.Possession of peak flow meter and use was low among the patients with only 22(20.8%) possessing a peakflow meter. Only 26 (24.5%) of the Asthmatics received any form of health education.
CONCLUSION: Asthma control remains poor among the patients in Lagos, Nigeria. Poor knowledge of disease, medication use and inhaler techniques contribute significantly to this problem.
CLINICAL IMPLICATIONS: This study emphasized the importance of educating the patients on their disease, medication uses, inhalation techniques and home monitoring of asthma.It also showed the need to train asthma nurses and re-train health personnel in the utilization of current guidelines in the management of asthma in Lagos, Nigeria.
DISCLOSURE: Olayinka Adeyeye, No Financial Disclosure Information; No Product/Research Disclosure Information