Assessment and management of asthma and chronic obstructive pulmonary disease in Australian general practice

Aust Fam Physician. 2017 Jun;46(6):413-419.

Abstract

Background: Dispensing data suggest potential issues with the quality use of medicines for airways disease.

Objective: The objective of this article was to describe the management of asthma and chronic obstructive pulmonary disease (COPD) in general practice, and investigate the appropriateness of prescribing.

Methods: The method used for this study consisted of a national cross‑sectional survey of 91 Australian general practitioners (GPs) participating in the Bettering the Evaluation and Care of Health (BEACH) program.

Results: Data were available for 2589 patients (288 asthma; 135 COPD). For the patients with asthma, GPs classified asthma as well controlled in 76.4%; 54.3% were prescribed inhaled corticosteroids (ICS), mostly (84.9%) as combination therapy, and mostly at moderate-high dose; only 26.3% had a written action plan. GPs classified COPD as mild for 42.9%. Most patients with COPD (60.9%) were prescribed combination ICS therapy and 36.7% were prescribed triple therapy.

Discussion: There were substantial differences between guideline-based and GP- recorded assessment and prescription for asthma and COPD. Further research is needed to improve care and optimise patient outcomes with scarce health resources.

MeSH terms

  • Administration, Inhalation
  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Asthma / epidemiology
  • Asthma / therapy*
  • Australia / epidemiology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Disease Management
  • Female
  • General Practice / methods*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Surveys and Questionnaires

Substances

  • Adrenal Cortex Hormones