Process of Care for Patients with Asthma in District Hospitals, Kalasin Province

Abstract

Introduction: Asthma is one of chronic respiratory diseases which can lead to hospitalization or readmission and even death. The objective of this study was to explore processes of care for patients with asthma including provision of service, assessment and

monitoring asthma severity and asthma control, and referral system in the district hospitals, Kalasin Province. Material and method: This was a descriptive study. Data collection was performed by interviiewing nurses and pharmacists who worked in asthma clinic at each hospital (N=13) using a developed questionnaire. Any documentation related to asthma care was also explored. Results: All hospitals provided a asthma clinic and had a guideline for asthma care. Lung function tests every follow-up visit were performed at asthma clinic in all hospitals. Nine hospitals assessed asthma control using Easy Asthma Clinic’s Form. Four hospitals assessed asthma control using their hospital forms which were developed based on GINA guideline 2008. Eleven hospitals monitored patient’s asthma control for step up or step down their medications. Pharmacists of all hospitals educated all new asthma patients on how to use Metered-Dose Inhaler (MDI) and assessed their inhaler technique. Ten hospitals had monitored patients’ inhaler technique. Ten hospitals had monitored patients who loss follow-up. Only one hospital referred out their patients to primary care unit (PCU). Inhaled coirticosteroid was available in all hospitals while combination inhaler that contains both a corticosteroid and a long-acting p2-agonist was found in eleven hospitals. Conclusion: Health care services for patients with asthma in the district hospitals in Kalasin Province tended to meet all aspects of quality of asthma care. However, there were some differences in process of care across hospitals.