Guidelines adherence in the treatment of asthma patients: Medication adjustment and outcomes, Samchuk hospital Suphanburi
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Introduction: The Global Initiative for Asthma (GINA) guideline is the treatment that is used around the world and also in Thailand. Because of the increasing of many new research studies every years, the initiative for Asthma was developed in 2002 and again in 2006 but it still was the problem in many countries including Thailand. The survey in Thailand found that the control for Asthma was under standard. In a year ago, there were 14.8 percentages for Asthma patients who had the serious symptom and stayed in the hospital. There was 21.7 percentages of Asthma patients that were sent into the emergency room after the Asthma was increased. Most of patients were not cured following the suggestions. The purpose of this study: was to assess the form of the medicine reducing treatment. The study design: was the cross-sectional study design that used for access the form of medicine reducing treatment and focuses on the result after used it at Samchuk Hospital, Suphanburi. To collect the information from 74 Asthma patients was from January 1, 2011 to December 31, 2012. To access the guideline adherence score by using the questionnaires that were created from the global invitation for Asthma (GINA) guideline, updated in 2012. The patients were divided into 2 groups. The first group, the patients were controlled by using the medicine reducing guideline. (The score was 70 percentages or more) The second group, the patients were free from GINA guideline. (The score was 69.90 or less) The outcome of medicine reducing treatment was checked for 1 year. They were about taking the tablet or injected Steroids, emergency visit, and staying at the hospital because of the Asthma symptom. The researcher collected the information from Asthma patients’ files. The description statistic was used in the study. The statistics that used for the data analysis were the average, the standard deviation, percentage and Chi-Square test. The results of this study: showed that 29 patients (39.19%) used the medicine reducing treatment and 45 patients (60.81%) did not use that treatment. Most of the patients (40 patients: 54.05%) had guideline adherence score between 60.00-69.90 percentages. When we checked the outcome for one year after taking the medicine, we found that in the first group (There were 2 patients: 6.89%) that used to take tablet or injected Steroids. The 6 patients (20.69%) at the emergency room. There was 1 patient (3.45%) stay in the hospital because of the Asthma exacerbation. The second group, the 13 patients (28.89%) took tablet or injected Steroids. There were 17 patients (37.78%) used to spray the drug extended pharynx at the emergency room. There were 1 patient (2.22%) stayed in the hospital. Chi-Square test was used for the data analysis and found that the controlled group of patients that used the medicine reducing treatment guideline got Steroids (tablet or injected) less than free controlled group statistically significant(p=0.022). The emergency room is not different (p=0.121) and to stay at the hospital because asthma exacerbation is not different (p=0.600) Conclusions: Patients who got high score from guideline adherence will have less percentage of severe asthma exacerbations than those patients with moderate score (50.0 to 69.9 percent). Chi-Square test was used for the data analysis and found that the controlled group of patients that used the medicine reducing treatment guideline got Steroids (tablet or injected) less than free controlled group statistically significant(p=0.022).
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