Healthcare providers and patient or caregiverOs perspective on patients with re-visit asthma exacerbation
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Abstract
Introduction: Asthma exacerbation is a condition that requires hospitalization visit oremergency department(ED). In Thailand, 15 percent of patients with asthma exacerbation were hospitalized and another 21 percent of these patients had visited an emergency department for treatment with inhalation.This results in alteration of patientcs quality of life. Therefore, asthma exacerbation-related factors are important and should be studied especially in healthcare provider and re-visit asthma patients perspectives in order to improve management of asthma in Thai patients. Objective: To explore healthcare providersand patient or caregivercs perspective on patients with asthma exacerbation. Methods: This is a qualitative descriptive study by in-depth interview. The 12 healthcare providers and 30 patients or caregivers who requiring emergency department visit at least 2 timeswith asthma exacerbationwere interviewed with sound record for 30 minute each. Interview was analyzed by content analysis method to determine healthcare providersand patients or caregivers point of view on causes of asthma exacerbation. Results: Data from the in depth interview showed that the major problems of asthma exacerbation from healthcare providerscperspectives were under diagnosis or a delay of diagnosis leading to a delay of treatment with inhaled corticosteroid. Causes ofproblems were outdated in treatment guideline, less detail provided in the guideline, healthcare provider team did not follow standard guideline, ineffective referral system for asthma patients in terms of patient information, and lack of holistic care. Other factors were inappropriate use of medication and presence of allergen. From perspectives of patient and caregiver, most common causes were weather change, no emergency bronchodilator supplies, missing appointments, self-medication use as well as incorrect technique of inhaler use. Conclusion: The major cause of asthma exacerbation was the problem with treatment guideline. Therefore, guideline development should be structured and reviewed to overcome these problems as it will be the most benefit to our patients.
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