Asthma affects a considerable number of people worldwide with people still dying unnecessarily from asthma attacks each day.
Owing to its impact on individuals and the society, asthma warrants a biopsychosocial, holistic approach which can best be provided by primary health care. However, social determinants, including the lack of universal health coverage and insufficient investment in primary care creates preventable harm, inequalities, and inequity within and between countries.
Asthma is often overlooked as a clinical, health and research priority in many countries despite significant opportunities to reduce variation and waste and improve quality and safety. Currently, a key problem in asthma management is the over-reliance on episodic care defined as a system-wide over-reliance on symptom relief and rescue. This includes over-reliance on by both prescribers, dispensers and patients on inhaled short-acting β2-receptor agonists (SABAs) and systemic steroids and the overuse of emergency services and hospitalisation, which may partly be caused by lack of adherence to the appropriate medication, the relative affordability of each option, and disregard of symptoms by patients.
In 2017, the International Primary Care Respiratory Group (IPCRG), the WONCA Europe Respiratory Special Interest Group, initiated a social movement, Asthma Right Care, to mobilise stakeholders firstly to acknowledge that problems exist and to take responsibility for resolving them.
To obtain a greater understanding of current asthma management worldwide, a survey based on the IPCRG’s situational analysis for its Teach the Teacher® programmes and structured according to IPCRG’s eight person-centred statements, was sent out as an online form to representatives from 47 countries where IPCRG had active contacts with practising clinicians. We received 57 responses from 33 countries.
This article analyses and discusses the results from the survey. In comparison to IPCRG’s description of good quality asthma care, key elements were reported missing in many of the countries, with variability present throughout asthma management, from diagnosis to treatment. The survey results reiterated the need for two things: primary care to engage in and lead the delivery of care for such a common condition, and for social movements such as ‘Asthma Right Care’ to address the inequity and inequality that remain in asthma management.
Call for responders: IPCRG has launched a new global survey to gain insights into the use of systemic steroids in asthma and COPD.
Here is the link to the survey: https://redcap.link/ipa5llqh Please complete and share widely with primary care prescribers and community pharmacists. The estimated time to complete this survey is 15-20 minutes.
The survey is open until May 31st, 2024, and can be completed in English, Portuguese and Spanish.
Jaime Correia de Sousa1",2", Siân Williams1
1"International Primary Care Respiratory Group, (IPCRG), UK
2"Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
Click here for the pdf