Burden, Clinical Aspects and Management of Bronchial Asthma at Outpatient Clinics in Jeddah Saudi Arabia

Abstract

Background: Asthma is a health disorder that is prevalent worldwide, and it imposes a great burden on primary health care (PHC) facilities. This work aims to study the magnitude and clinical aspects of bronchial asthma (BA) and to explore the pattern of its management at outpatient clinics (OPCs) in Jeddah, Saudi Arabia. Methods: A cross-sectional study enrolled 2,501 patients who visited the OPCs at two private hospitals in Jeddah during the study period. All patients were examined by a specialist. Data were collected using a checklist form to obtain personal characteristics, clinical assessment and management, as well as the outcome of the visits. Results: BA accounts for 4.27% of all visits, and for 19.49% of respiratory disorders visits to OPCs. Children under 6 years old were twice as likely to develop BA (OR: 1.89; 95% CI: 1.130, 3.147, p <0.015) compared to individuals older than 40 years. The common BA symptoms were cough (77.4%), dyspnea (42.5%), wheeze (29.2%), and sputum production (25.7%). CXR was the most frequent investigation performed on patients with BA (26.4%). No lung function or immunological tests were performed. Cortisol (21.7%), short-acting β2 agonist (21.7%), antibiotic (41%), paracetamol (17%), cough syrup and antihistamines (30% and 19.8%), and additionally, ketotifen (4.7%) and anti-leukotriene (7.5%) were prescribed to the patients. Counseling was neglected by physicians. The majority of cases were discharged. Conclusion: BA is a common cause for PHC visits. OPC management and use of antibiotics for BA should be revised with emphasis on adherence to the standard recommendations. PHC physicians should prioritize educating people about the prevention and control of BA.