Bridging the Gap Between Guidelines and Clinical Practice: An Audit of Asthma Management

Background: To assess clinical practice in the light of GINA guidelines and to identify and rectify areas of weaknesses in current clinical practice so as to provide GINA guidelines described standard of care to our patients. Methods: In this descriptive study 50 consecutive asthma patients were audited prospectively.Patient demographics were recorded. Every patient underwent detailed clinical evaluation as well as objective assessment by spirometry. Results: The mean age was 43 years with female predominance (66%). Fifty eight percent had a family history of asthma and 90% belonged to lower middle and lower classes. Diagnosis of asthma was made on clinical grounds in 90% and only 10% of patients had objective confirmation of asthma by spirometry. Fifty two percent of the patients were on suboptimal treatment according to disease severity and only 30% had correct inhaler technique. Only 40% were compliant with the prescribed treatment and only 36% had good control of asthma. Conclusion: Discrepancy in the theoretical instructions (GINA guidelines) and the clinical practice was observed in our setting. Majority of patients were on sub-optimal treatment with incorrect inhaler technique leading to poor asthma control.