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Background:
More than a million
visits/year
characterize acute
asthma morbidity at
Venezuelas (24
million inhabitants)
Ministry of Health
ambulatory services,
caring for 80% or
more of the
population; acute
morbidity from
asthma is second to
viral syndrome but
ahead of diarrhea
and other diseases.
These acute episodes
are the
only contact of a
poor asthmatic child
with this health
care system and
portray the
prevailing approach
focused around acute
care; to be reversed,
a simple cost/effective
program ought to be
implemented during
these acute asthma
visits. Since
convenience of
administration is a
key factor in
compliance, a pilot
study to explore the
efficacy
of budesonide CFC
400 µg administered
on a once-a-day
basis for adherence
was carried out
within a
naturalistic
realworld design.
Methods:
Thirty persistent
asthmatic patients
attending the
Allergology Unit of
the Hospital
Pediátrico San Juan
de Dios in Caracas
were enrolled, and
their asthma signs/symptoms
quantified and
registered on diary
cards (0-3 scale) as
well as peak flow
measurements in am/pm
for a period of 2
weeks prior to
budesonide
administration
(control data) and
until completion of
study. Only 12 (mean
age: 9 years) of the
initial patients
were able to
properly keep a
diary and scheduled
visits for a period
of 15 weeks.
Results: Data
allowed comparison
between pre- and
posttreatment
symptoms/signs
scores and PF values.
After 3 weeks
treatment with
budesonide,
statistically
significant
improvements were
shown for all
parameters, except
for PF, whose minor
improvements did not
reach statistical
significance.
Conclusions:
Budesonide CFC 400
µg administered once
a day seems
effective in control
of asthma signs/symptoms
within study design.
Confirmation of the
above findings in
larger groups of
patients, treated
similarly and for
longer periods of
time, seems
justified. A simple
cost-effective
intervention,
analogous
conceptually to the
proven successful
oral rehydration
therapies for
diarrhea in public
health, should be
considered in third
world countries with
high urban asthma
prevalence.
Key words:
children, asthma,
third world,
approach, cost-effectiveness. |
