Study of pattern of drug treatment in patients with exacerbations of bronchial asthma in an emergency ward of a teaching hospital: A prospective, cross sectional study

Exacerbations of bronchial asthma is one of the common presenting complaints affecting all age groups. There has been a recent increase in the incidence of asthma with a parallel increase in the number of drugs available for its treatment. The present study was aimed at evaluating prescribing pattern of medications in exacerbations of bronchial asthma and to compare it with National Asthma Education and Prevention Programme (NAEPP) guidelines. This was a prospective, cross sectional, observational study in patients > 18 years of age, reporting with exacerbations of bronchial asthma. The demographic, disease and drug treatment data, was collected from each patient from the Emergency Medicine Ward [EMW] and was analysed descriptively. Total of 400 patients reporting at EMW with exacerbations of bronchial asthma were analyzed for disease profile and drug treatment aspects. Severity of exacerbation, based on NAEPP guidelines, 17% belong to severe, 52% moderate and 30% mild category. After initial treatment at EMW 34% patients were discharged, 64% got shifted to general ward for further treatment and 2% to Intensive care unit. Overall the use of salbutamol and ipratropium by nebulization was 100% and 80% respectively. Patients with severe and moderate exacerbation of asthma, non-responsive to nebulization in addition received systemic steroids with mask oxygen and I.V. theophylline . The use of alternative systems of medicine was seen among 17% and adverse drug reactions in 15% of patients. The drug treatment data was compared with NAEPP guidelines. In the present study drug treatment pattern for exacerbations of asthma did not match completely with NAEPP guidelines. Therefore there is a need to bring awareness among physicians about NAEPP treatment guidelines. Also the influence of concomitant use of alternative systems of medicine will need further evaluation.