[Survey among chest physicians regarding the diagnosis and management of asthma].

A survey on asthma management was conducted in 300 chest physicians randomized from a national list. Diagnosis procedures, methods for recognizing life-threatening asthma attacks and patient education about his or her disease were reviewed. Ninety-eight responses were obtained (32.7% of the questionnaires mailed). 71% of the responders were specialized in respiratory medicine (RM), 12% in RM + Internal Medicine (IM), 6% in RM + Allergy (A), 5% in A, 4% in IM, and 2% in IM + A. As a diagnostic test, immediate response to bronchodilator was seldom used and a trial course of oral steroids was even less used. Blood eosinophilia and specific IgE RAST were frequently used and more than in other compared countries in spite of its doubtfulness for the diagnosis of asthma. Severity of asthma attack was assessed less than in other countries in relation to symptoms, lack of response to inhaled bronchodilators and with practically no use of any objective method for the assessment of airways obstruction (PEFR). The latter was seldom employed for chronic control of the disease. The assessment of the correct technique of metered dose inhaler or dry powder inhaler use was rarely done. Only the questions referred to patient education about their disease, teaching about the difference between relieving (bronchodilator) and anti-inflammatory treatment, communication to the patient about the severity of his or her disease and the frequency of giving a written action plan in case of severe asthma attacks qualified equal or better than countries that always qualified well. These responses, together with other data of the literature, makes us suspect, as is common in these audits, that the interviewed person sometimes replies what he or she should do, but not necessarily what he or she does.