Family Practice Vol. 19, No. 5, 448-451
© Oxford University Press 2002
Outcomes of an intervention programme for treatment of asthma in a primary care clinic for Bedouins in southern Israel
a Department of Family Medicine and
d Division of Health in the Community, Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel,
b Kuseife Clinic, Clalit Health Services, Southern Region and
c Southern Region Administration, Clalit Health Services.
Roni Peleg, MD, Department of Family Medicine, Ben-Gurion University, POB 653, Beer-Sheva, Israel, 84105; E-mail: pelegr{at}bgumail.bgu.ac.il
Background. Asthma is one of the most common disorders affecting children and adults. There is a large variation in the theoretical and practical knowledge and skills of physicians, and patients often do not receive optimal treatment. Thus, asthma represents a great challenge to the primary health care system
Objective. Our aim was to evaluate an intervention programme for the optimization of treatment of asthma in a primary care clinic in the Muslim Bedouin sector in southern Israel.
Methods. Over a 3-month period, data were collected on the number of nebulizer treatments received by asthma patients in the clinic, referrals to the emergency room, hospitalizations and availability of electric nebulizer equipment or space chambers in the homes of children with asthma. Following this, an intervention programme was designed and implemented to improve treatment of asthma. At the end of the intervention 1 year later, the same data were again collected in the same season as the pre-intervention data.
Results. Of 3428 children registered in the clinic, 267 were diagnosed with asthma (7.8%). During the 3-month period before the intervention, 73 children had home inhalation equipment, 61 referrals to the emergency room were documented and six children were hospitalized for exacerbation or complications of the disease. Over this time period, 5.54 nebulizer treatments were conducted in the clinic per month per 100 children and adults. Following the intervention, the number of referrals to the emergency was reduced to six children, none of whom was hospitalized. The number of children with home nebulizers was doubled. The number of nebulizer treatments in the clinic dropped to 4.7 per month per 100, a reduction of 15%.
Conclusions. An intervention including self-management of asthma with an emphasis on the proper use of inhalers and medications, together with improved disease management at the clinic itself, led to a reduction in the episodes of asthma and its complications.
Keywords. Asthma, Bedouins, family medicine, paediatric care, quality of care.