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Undertreatment of asthma in Dutch general practice
A A Kaptein1, F W Dekker, K Gill
1Department of General Practice, University of Leiden, The Netherlands.
Abstract:
The relationships between the medication prescribed and four measures of morbidity were assessed in 150 Dutch patients with asthma in general practice. Undertreatment was operationalized as a discrepancy between medication and morbidity severity. Of the patients, 11.3% were undertreated as measured by the number of days during which activities were interrupted by asthmatic symptoms. Additional measures such as the number of nights interrupted by asthma, number of attacks and episodes of wheezing, indicated that 28.0%, 24.0% and 34.5% of the patients respectively were undertreated. It is concluded that asthma seems to be undertreated in general practice in The Netherlands, a finding which is consistent with research on this subject in the UK and other countries. Possible reasons for the persistence of undertreatment of asthma are discussed, and suggestions for overcoming it are offered.
Insights
Asthma undertreatment is prevalent in Dutch general practice, affecting over 10% of patients based on symptom severity. This study highlights a gap between prescribed medication and actual patient morbidity, indicating a need for improved asthma management strategies.
Area of Science:
- Pulmonary Medicine
- General Practice
- Pharmacoeconomics
Background:
- Asthma management in general practice requires careful consideration of medication relative to disease severity.
- Undertreatment, defined as inadequate medication for a given level of morbidity, is a potential concern in chronic disease management.
Purpose of the Study:
- To assess the extent of asthma undertreatment in Dutch general practice.
- To examine the relationship between prescribed asthma medication and patient-reported morbidity.
Main Methods:
- A study involving 150 Dutch patients with asthma in general practice.
- Undertreatment was defined as a discrepancy between prescribed medication and four measures of morbidity (symptom-related activity interruption, night interruption, asthma attacks, wheezing episodes).
Main Results:
- 11.3% of patients were undertreated based on activity interruption due to asthma symptoms.
- Additional morbidity measures indicated higher undertreatment rates: 28.0% (nights interrupted), 24.0% (attacks), and 34.5% (wheezing episodes).
Conclusions:
- Asthma appears to be significantly undertreated in general practice in The Netherlands.
- Findings align with international research, suggesting a widespread issue in asthma care.
- The study discusses potential reasons for undertreatment and proposes solutions for improvement.