Healthcare providers and patient or caregiver’s perspective on patients with re-visit asthma exacerbation

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 Causes  ofproblems  were  outdated  in  treatment guideline,  less  detail  provided  in  the  guideline,  healthcare  provider  team  did  not  follow  standard  guideline, ineffective 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.