Assessment of care of patients with asthma in a family practice training program

To determine if primary care physicians have been adhering to guidelines set forth by the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel Report Guidelines for the Diagnosis and Management of Asthma, the author gauged the use of peak flow meters in a hospital family training program. Specifically investigated were the physicians' response to results from the peak flow meters and their prescribing practices regarding the beclomethasone dipropionate metered-dose inhaler. Overall, the use of peak flow meters among the 20 patients included in this study averaged 70%, up from 10% in earlier studies. Similarly, 45% of these patients received prescriptions for beclomethasone metered-dose inhalers with spacer devices. Although these results appear to indicate that physicians are following the aforementioned guidelines, the author cautions that the peak expiratory flow rate measurement is not a perfect indication of asthma severity. Likewise, the spacer devices are not indicated for all patients with asthma who are taking inhaled corticosteroids. Finally, the author emphasizes that anti- inflammatory agents should be effectively used when indicated.