Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
UMeHealth Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
NPJ Prim Care Respir Med. 2023 Mar 27;33(1):13. doi: 10.1038/s41533-023-00337-8.
Asthma, a common chronic respiratory illness is mostly managed in primary care. We aimed to determine healthcare resources, organisational support, and doctors' practice in managing asthma in a Malaysian primary care setting. A total of six public health clinics participated. We found four clinics had dedicated asthma services. There was only one clinic which had a tracing defaulter system. Long-term controller medications were available in all clinics, but not adequately provided. Resources, educational materials, and equipment for asthma management were present, though restricted in number and not placed in main locations of the clinic. To diagnose asthma, most doctors used clinical judgement and peak flow metre measurements with reversibility test. Although spirometry is recommended to diagnose asthma, it was less practiced, being inaccessible and unskilled in using as the main reasons. Most doctors reported providing asthma self-management; asthma action plan, but for only half of the patients that they encountered. In conclusion, there is still room for improvement in the provision of clinic resources and support for asthma care. Utilising peak flow metre measurement and reversibility test suggest practical alternative in low resource for spirometry. Reinforcing education on asthma action plan is vital to ensure optimal asthma care.
哮喘是一种常见的慢性呼吸道疾病，主要在初级保健中进行管理。我们旨在确定马来西亚初级保健环境中管理哮喘的医疗资源、组织支持和医生实践。共有六家公立卫生诊所参与了这项研究。我们发现有四家诊所提供了专门的哮喘服务。只有一家诊所设有追踪未就诊患者的系统。所有诊所都提供长期控制药物，但提供不足。哮喘管理的资源、教育材料和设备都有，但数量有限，且未放置在诊所的主要位置。为了诊断哮喘，大多数医生使用临床判断和峰值流量计测量以及可逆性测试。尽管推荐使用肺活量计来诊断哮喘，但由于无法获得和缺乏使用技能，其使用较少，这是主要原因。大多数医生报告提供了哮喘自我管理和哮喘行动计划，但仅针对他们遇到的一半患者。总之，在提供诊所资源和支持哮喘护理方面仍有改进的空间。利用峰值流量计测量和可逆性测试表明，在资源有限的情况下，肺活量计是一种实用的替代方法。加强对哮喘行动计划的教育对于确保最佳哮喘护理至关重要。
