Para ofrecer atención de calidad al niño-adolescente conasma es necesario: la capacitación de los profesionales implicados, estructura y recursos para desarrollar el trabajoeficazmente y satisfacción del usuario como medida delcumplimiento de sus expectativas. Los objetivos del trabajo son: conocer la situación actual del manejo del pacientecon asma por el pediatra de atención primaria y promoverla mejora en la asistencia y calidad de vida de estos niños ysus familias.
Material y métodosEstudio descriptivo: encuesta realizada a pediatras asistentes a los cursos sobre asma impartidos por el Grupo deVías Respiratorias de la Asociación Española de Pediatríade Atención Primaria, durante 2001.
ResultadosSe han realizado 323 encuestas. Edad media, 42 años;mujeres, 70,6 %. Derivan todos los pacientes al neumólogo, 7,4 %; al alergólogo, 21,3 %; sólo derivan asma modera-da-grave, 61,9 %. Registran en la historia clínica el diagnostico de asma codificada, 32,5 %; la clasificación degravedad, 61 %. Disponen de espirómetro 48,6 %; de medidor de flujo espiratorio máximo (MFEM), 45,5 %. Realizan estudio de función pulmonar: espirometría, 17,3 %;MFEM, 33,2 %. Educación: sobre factores desencadenantes,90,4 %; técnica inhalatoria, 81,7 %; plan de acción escrito,41,2 %.
ConclusionesEl estudio muestra por primera vez resultados de la situación actual del tratamiento del paciente con asma porel pediatra de atención primaria en España.
Los datos muestran la necesidad de: mejorar los registros, disponer y optimizar los recursos para el diagnóstico y seguimiento y priorizar la educación para conseguir el máximo nivel de automanejo por el paciente y familiares.
To provide good asthma care to children and adolescents the following conditions are required: well-trained health professionals with the structure and resources necessary to perform their work efficiently, and client satisfaction as a measure of compliance and self-management. The aims of this study were to determine the current situ-ation of asthma management by primary care pediatricians and to promote improvement of the healthcare and quality of life of these children and their families.
Material and methodsWe performed a descriptive study. A questionnaire was completed by primary care pediatricians attending asthma courses given by the Respiratory Team of the Spanish Association of Primary Care Pediatrics in 2001.
ResultsThree hundred twenty-three questionnaires were completed. The mean age of the pediatricians was 42 years and 70.6% were women. A total of 7.4% referred all patients tothe pediatric pneumologist and 21.3% referred all patientsto the pediatric allergy clinic; 61.9% referred only patientswith moderate-severe persistent asthma. Concerningitems registered in medical records, 32.5% recorded acodified asthma diagnosis and 61% included severity classification. Spirometers were available to 48.6% and peak flow meters to 45.5%. With regard to lung function measurement, 17.3% performed spirometry and 33.2% performed peak expiratory flow. Concerning asthma educational issues, 90.4% had received education on environmental factors, 81.7% had received training in the proper use of medication inhalers and 41.2% had received training in written self-management plans.
ConclusionsThis is the first study to present results on the current situation of asthma management by primary care pediatricians in Spain.
The results show the need to improve record-keeping, facilitate the resources required for diagnosis and follow-up and prioritize education in order to achieve an optimal level of self-management by patients and their families.