Asthma as a hidden disease in rural China: opportunities and challenges of standard case management

X H Kan, Chen-Yuan Chiang, Donald A. Enarson, H L Rao, Q. Chen, N. Aït-Khaled, G. W. Chen

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To assess the implementation of standard case management of asthma in Huaiyuan County, Anhui Province, China, in 2008.

DESIGN: The study project began with the local adaptation of international asthma guidelines, followed by a situation analysis, pre-intervention study, training and intervention. Inhaled beclomethasone (US$15 for a 200-puff [250 µg/puff] inhaler) was prescribed for patients with persistent asthma. Treatment outcome was assessed at 1 year after enrolment.

RESULTS: Asthma was never diagnosed in the participating facilities before the project was introduced. Of the 95 patients diagnosed with persistent asthma, 72 (75.8%) were prescribed inhaled beclomethasone, and 23 (24.2%) were not, because they either refused to use inhaled beclomethasone or did not return after the initial visit. At 1 year evaluation, of the 72 patients with persistent asthma treated with inhaled corticosteroids, 12 (16.7%) improved, 7 (9.7%) remained stable, none were worse, 1 (1.4%) had died, and 52 (72.2%) were lost to follow-up. Of the 52 patients lost to follow-up, 25 (48%) were found to be alive but had stopped using inhaled beclomethasone.

CONCLUSION: Asthma is more frequently disabling and costly than had been recognised earlier. Asthma patients can be provided the care that they require, but affordable access to inhaled corticosteroids remains a challenge.

Original languageEnglish
Pages (from-to)87-91
Number of pages5
JournalPublic Health Action
Volume2
Issue number3
DOIs
Publication statusPublished - Sep 21 2012

Fingerprint

Case Management
China
Asthma
Beclomethasone
Lost to Follow-Up
Adrenal Cortex Hormones
Nebulizers and Vaporizers
Guidelines

Keywords

  • Journal Article

Cite this

Asthma as a hidden disease in rural China : opportunities and challenges of standard case management. / Kan, X H; Chiang, Chen-Yuan; Enarson, Donald A.; Rao, H L; Chen, Q.; Aït-Khaled, N.; Chen, G. W.

In: Public Health Action, Vol. 2, No. 3, 21.09.2012, p. 87-91.

Research output: Contribution to journalArticle

Kan, X H ; Chiang, Chen-Yuan ; Enarson, Donald A. ; Rao, H L ; Chen, Q. ; Aït-Khaled, N. ; Chen, G. W. / Asthma as a hidden disease in rural China : opportunities and challenges of standard case management. In: Public Health Action. 2012 ; Vol. 2, No. 3. pp. 87-91.
@article{620369b13c3446abbd61fae70c91fcb6,
title = "Asthma as a hidden disease in rural China: opportunities and challenges of standard case management",
abstract = "OBJECTIVE: To assess the implementation of standard case management of asthma in Huaiyuan County, Anhui Province, China, in 2008.DESIGN: The study project began with the local adaptation of international asthma guidelines, followed by a situation analysis, pre-intervention study, training and intervention. Inhaled beclomethasone (US$15 for a 200-puff [250 µg/puff] inhaler) was prescribed for patients with persistent asthma. Treatment outcome was assessed at 1 year after enrolment.RESULTS: Asthma was never diagnosed in the participating facilities before the project was introduced. Of the 95 patients diagnosed with persistent asthma, 72 (75.8{\%}) were prescribed inhaled beclomethasone, and 23 (24.2{\%}) were not, because they either refused to use inhaled beclomethasone or did not return after the initial visit. At 1 year evaluation, of the 72 patients with persistent asthma treated with inhaled corticosteroids, 12 (16.7{\%}) improved, 7 (9.7{\%}) remained stable, none were worse, 1 (1.4{\%}) had died, and 52 (72.2{\%}) were lost to follow-up. Of the 52 patients lost to follow-up, 25 (48{\%}) were found to be alive but had stopped using inhaled beclomethasone.CONCLUSION: Asthma is more frequently disabling and costly than had been recognised earlier. Asthma patients can be provided the care that they require, but affordable access to inhaled corticosteroids remains a challenge.",
keywords = "Journal Article",
author = "Kan, {X H} and Chen-Yuan Chiang and Enarson, {Donald A.} and Rao, {H L} and Q. Chen and N. A{\"i}t-Khaled and Chen, {G. W.}",
year = "2012",
month = "9",
day = "21",
doi = "10.5588/pha.12.0025",
language = "English",
volume = "2",
pages = "87--91",
journal = "Public Health Action",
issn = "2220-8372",
publisher = "International Union Against Tuberculosis and Lung Disease (The Union)",
number = "3",

}

TY - JOUR

T1 - Asthma as a hidden disease in rural China

T2 - opportunities and challenges of standard case management

AU - Kan, X H

AU - Chiang, Chen-Yuan

AU - Enarson, Donald A.

AU - Rao, H L

AU - Chen, Q.

AU - Aït-Khaled, N.

AU - Chen, G. W.

PY - 2012/9/21

Y1 - 2012/9/21

N2 - OBJECTIVE: To assess the implementation of standard case management of asthma in Huaiyuan County, Anhui Province, China, in 2008.DESIGN: The study project began with the local adaptation of international asthma guidelines, followed by a situation analysis, pre-intervention study, training and intervention. Inhaled beclomethasone (US$15 for a 200-puff [250 µg/puff] inhaler) was prescribed for patients with persistent asthma. Treatment outcome was assessed at 1 year after enrolment.RESULTS: Asthma was never diagnosed in the participating facilities before the project was introduced. Of the 95 patients diagnosed with persistent asthma, 72 (75.8%) were prescribed inhaled beclomethasone, and 23 (24.2%) were not, because they either refused to use inhaled beclomethasone or did not return after the initial visit. At 1 year evaluation, of the 72 patients with persistent asthma treated with inhaled corticosteroids, 12 (16.7%) improved, 7 (9.7%) remained stable, none were worse, 1 (1.4%) had died, and 52 (72.2%) were lost to follow-up. Of the 52 patients lost to follow-up, 25 (48%) were found to be alive but had stopped using inhaled beclomethasone.CONCLUSION: Asthma is more frequently disabling and costly than had been recognised earlier. Asthma patients can be provided the care that they require, but affordable access to inhaled corticosteroids remains a challenge.

AB - OBJECTIVE: To assess the implementation of standard case management of asthma in Huaiyuan County, Anhui Province, China, in 2008.DESIGN: The study project began with the local adaptation of international asthma guidelines, followed by a situation analysis, pre-intervention study, training and intervention. Inhaled beclomethasone (US$15 for a 200-puff [250 µg/puff] inhaler) was prescribed for patients with persistent asthma. Treatment outcome was assessed at 1 year after enrolment.RESULTS: Asthma was never diagnosed in the participating facilities before the project was introduced. Of the 95 patients diagnosed with persistent asthma, 72 (75.8%) were prescribed inhaled beclomethasone, and 23 (24.2%) were not, because they either refused to use inhaled beclomethasone or did not return after the initial visit. At 1 year evaluation, of the 72 patients with persistent asthma treated with inhaled corticosteroids, 12 (16.7%) improved, 7 (9.7%) remained stable, none were worse, 1 (1.4%) had died, and 52 (72.2%) were lost to follow-up. Of the 52 patients lost to follow-up, 25 (48%) were found to be alive but had stopped using inhaled beclomethasone.CONCLUSION: Asthma is more frequently disabling and costly than had been recognised earlier. Asthma patients can be provided the care that they require, but affordable access to inhaled corticosteroids remains a challenge.

KW - Journal Article

UR - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463046/

U2 - 10.5588/pha.12.0025

DO - 10.5588/pha.12.0025

M3 - Article

C2 - 26392959

VL - 2

SP - 87

EP - 91

JO - Public Health Action

JF - Public Health Action

SN - 2220-8372

IS - 3

ER -