Understanding medication and use of drug delivery device by asthmatic in Lagos

There are several internationally accepted guidelines for the management of asthma.

To examine 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 in Lagos, Nigeria.

One hundred and six 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. The patients aged between 13 and 64 years were interviewed about asthma control using previous hospitalization, frequency of night-time symptoms, and frequency of attendance at The Emergency Unit. Their knowledge of medications was assessed. Inhaler techniques were directly observed.

Fifty two (49.1%) had previous hospitalization for asthma. Fifty (47.2%) had weekly nighttime symptoms. Forty-eight (45.3%) had exacerbations requiring treatment at the emergency room in the week preceeding the interview. The metered dose inhaler was the commonest drug delivery device, in use by 72 (67.9%) of the patients. Thirty-two (30.2%) used diskus. Only 10 (10.6%) used nebulisers at any point. The inhaler technique was rated as good by thirty-four (47.2%) out of the seventy-two respondents and poor by thirty-eight (52.8%). Only thirty-four satisfactorily performed all steps. One hundred respondents (943%) skipped their medications. Majority of the asthmatics did not receive any health education about their condition. Possession of peak flow meter and use were low among the patients with only 22 (20.8%) having one.

Asthma control is poor among the patients in Lagos, Nigeria. Poor knowledge of disease, medication use and inhaler techniques contribute significantly to this problem.