Unmet needs in asthma treatment in a resource-limited setting: findings from the survey of adult asthma patients and their physicians in Nigeria

• Published in: The Pan African medical journal Vol. 16; p. 20
• Main Authors: Desalu, Olufemi Olumuyiwa, Onyedum, Cajetan Chigozie, Adeoti, Adekunle Olatayo, Ozoh, Obianuju Beatrice, Fadare, Joseph Olusesan, Salawu, Fatai Kunle, Danburam, Ali, Fawibe, Ademola Emmanuel, Adewole, Olanisun Olufemi
• Format: Journal Article
• Language: English
• Published: Uganda The African Field Epidemiology Network 2013
• Subjects: Adult; Asthma - economics; Asthma - epidemiology; Asthma - psychology; Asthma - therapy; Cross-Sectional Studies; Female; Health Resources - economics; Health Resources - supply & distribution; Health Services Needs and Demand; Humans; Male; Middle Aged; Nigeria - epidemiology; Perception; Physician-Patient Relations; Poverty; Professional Practice - economics; Professional Practice - statistics & numerical data; Young Adult; Nigeria; barriers; education; treatment compliance; side effects; communication; treatment practices; Asthma
• ISSN: 1937-8688
• DOI: 10.11604/pamj.2013.16.20.2798

The prevalence of asthma in our society is rising and there is need for better understanding of the asthma patients' perception and treatment practice of physicians. The study was aimed at determining asthma attitudes and treatment practices among adult physicians and patients in Nigeria, with the goal of identifying barriers to optimal management. To assess asthma attitudes, treatment practices and limitations among adult physicians and patients in Nigeria, a questionnaire survey was conducted among 150 patients and 70 physicians. Majority (66.7%) of the patients reported their asthma as moderate to severe, 42.7% had emergency room visit and 32% had admission due to asthma in the previous 12 months. Physicians and patients perceptions significantly differed in the time devoted to educational issues (31.4% vs.18.7%) and its contents: individual management plan (64.3% vs.33.3%), correct inhaler technique (84.0% vs.71.0%), medication side effects (80.0% vs.60.0%) and compliance 100% of time (5.7% vs. 18.7%). Patients reported that non-compliance with medication causes increased symptoms (67.0%), exacerbations (60.0%), bronchodilator use (56.0%), urgent physician visit (52.0%) and hospitalizations /ER visits (38.7%). Asthma medication in patients caused short term (10.7%) and long term side effects (20.0%). Due to side effects, 28.0% skipped and stopped their medications. Most physicians (85.7%) and patients (56.0%) agreed on the need for new medication options. The need for new medication in patients was strongly related to asthma severity, limitation of activities, side effects, cost and lack of satisfaction with current medication. With the exception of pulmonologists, physicians did not readily prescribe ICS and their prescriptions were not in line with treatment guidelines. This study has highlighted the gaps and barriers to asthma treatment which need to be addressed to improve the quality of care in Nigeria.