Prescribing for asthmatic children in primary care. Are we following guidelines?

OBJECTIVE: Guidelines for asthma management have been developed both locally and internationally. The aim of this study was to evaluate the adherence of primary care physicians in the National Guard Iskan Primary Care Center to these guidelines.

METHODS: The records of 206 asthmatic children who visited the National Guard Iskan Primary Care Center, Jeddah, Kingom of Saudi Arabia, during the months of February 1998 through June 1998, were reviewed. The following data was extracted from them; presenting symptoms, number of visits, names of asthma medications, whether doses were documented or not and number of times antitussives were prescribed.

RESULTS: The most common presenting complaint was cough followed by wheeze and shortness of breath (mean ± SD, 14 ± 13.8, 8.8 ± 10.3 and 4.4 ± 5.8). Oral salbutamol was the most frequently prescribed medication. The doses of asthma medications were not documented in 37.3% of cases. Preventive therapy was prescribed to 35.4% of children and emergency steroids were prescribed to 30.6% of children. The mean age of asthmatic children receiving inhaled medications was significantly higher than those other forms of therapy (p<0.00001). Antitussives were prescribed 2,536 times (mean 12.3).

CONCLUSION: Prescribing for asthmatic children did not conform to national guidelines for treatment of asthma. These findings suggest that ways need to be found: (i) to increase the use of current asthma management guidelines by practitioners; (ii) to improve documentation of prescribed medications and their dosage and; (iii) to improve education of parents in home management measures.