Assessment of Primary Care Doctors’ Practice Regarding Asthma Management in Health Centers in Khartoum State, Sudan, 2017
Hind Mustafa Elwarrag
State Ministry of Health, Khartoum, Sudan.
Sayed Halay *
Department of Community Medicine, Faculty of Medicine, University of Khartoum, Sudan.
Heitham Awadalla
Department of Community Medicine, Faculty of Medicine, University of Khartoum, Sudan.
Siham Ahmed Balla
Department of Community Medicine, Faculty of Medicine, University of Khartoum, Sudan.
Osman Hamid Abdulhamid
Department of Family and Community Medicine, Faculty of Medicine, University of Gazira, Sudan.
*Author to whom correspondence should be addressed.
Abstract
Background: Primary health care (PHC) is the gateway to the health system, and is expected to resolve up to 85% of health problems in general. Sub-optimal management of asthma can be attributed to patient’s, doctor’s or health services’ factors. The aim of this study was to assess the Primary care doctors’ practice regarding asthma management in health centers in Khartoum State, Sudan.
Methods: This is a descriptive cross-sectional health facility based study in which a pre-tested self-administered questionnaire was used to collect information from the primary care doctors regarding their practice in asthma management.
Results: Of 131 primary care doctors (PCDs), covering 29 health centers, 87% of them were females and 75.5% were family medicine specialists (registrars and physicians). The majority of PCDs (>90%) identified environmental triggers/inducers of asthma and checked for treatment adherence at each visit. More than half of the PCDs (50%-89%) addressed patients concerns about disease/treatment, provided smoking cessation counseling and/or recommended cessation measures, and prescribed an inhaled corticosteroid (ICS) as initial maintenance therapy. Less than half of them (<50%) provided a written action plan for both exacerbation management and asthma education.
Conclusion: Although the results were acceptable and comparable in most aspects of managing asthma there was a considerable gap between practice and known guidelines on asthma management. There is an urgent need to develop and implement a national protocol on asthma management.
Keywords: Asthma management, health centers, practice, primary care doctors, Khartoum State, Sudan