Allergist role in asthma care in Puerto Rico

Puerto Ricans have one of the highest asthma prevalence and morbidity rates. However, limited information is available on asthma care and attitudes toward asthma treatment among Puerto Ricans living in the island.

We evaluated a cohort of subjects attending Ambulatory Health Screen Clinic in the two main cities in the north and south of the island during August of 2008. Subjects attending the clinic answered a survey about asthma care and attitudes toward asthma treatment. Approval was obtained from the Medical Sciences IRB and written informed consent obtained from all research subjects before enrollment.

According to subject report, asthma care is primarily conducted by primary care physicians including pediatricians (35.8%), general practitioners (31.4%), and family physicians (4.3%). Pulmonary physicians conducted 23.3% of asthma care and allergists conduct 3.6%. Only 65.5 % reported using prescribed asthma medications. Fear of medication side effects (37.7%), lacks of health insurance coverage (26.4%), and medication cost (15.1%) were the most common causes reported for poor compliance. Subjects considered that physicians were one of the best sources (68.1%) for information on asthma, followed by the TV (23.7%) and the web (15.4%).

Most asthma care in Puerto Rico is conducted by primary care providers. Subspecialists have a limited role and particularly allergists. Efforts to increased public and physician awareness of the role of allergists in asthma care in Puerto Rico are warranted.