Implementation of GINA guidelines in Ho Chi Minh City: a model for Viet Nam

Area of Science:

• Pulmonology
• Public Health
• Health Economics

Background:

• The Global Initiative for Asthma (GINA) guidelines are crucial for effective asthma management but face implementation challenges in primary care settings.
• Viet Nam has historically seen suboptimal adherence to GINA guidelines in its primary care system.

Purpose of the Study:

• To assess the effectiveness of GINA guideline implementation in improving asthma control.
• To determine the direct healthcare costs associated with asthma management under GINA guidelines.
• To evaluate clinical and pulmonary function outcomes in patients treated according to GINA guidelines.

Main Methods:

• A 12-month prospective study involving 106 asthma patients at four out-patient clinics in Ho Chi Minh City, Viet Nam.
• Patients were treated and monitored following GINA guidelines, with evaluations every three months.
• Data collected included clinical responses, pulmonary function tests, and direct healthcare costs.

Main Results:

• Asthma control improved significantly, with the proportion of controlled patients increasing from 1.0% to 36.8% (P < 0.0001).
• Annual hospitalizations per patient decreased substantially from 32.1% to 5.7% (P < 0.0001).
• The median annual direct healthcare cost per patient was US$169, and continuous use of controllers improved control (OR 12.9).

Conclusions:

• Implementing GINA guidelines in Ho Chi Minh City out-patient clinics effectively enhanced asthma control.
• The study demonstrated that GINA guideline implementation is associated with manageable direct healthcare costs.
• Adherence to GINA guidelines represents a viable strategy for improving asthma outcomes in similar primary care settings.