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Objective: To describe the approach to asthma exacerbations in a primary care centre in comparison with current guidelines and to ascertain the resolution of the episodes., Methods: A cross-sectional, descriptive study was performed in asthmatic patients over 14 years old who were consulting for asthma exacerbations in a primary care centre during a 6-month period. The treatment given and the resolution obtained were evaluated., Results: One hundred and twenty-three asthma exacerbations were registered, corresponding to 96 patients. A total of 74% were mild exacerbations, 24.4% moderate and 1.6% severe. The severity of asthma correlated directly with the severity of exacerbations. The frequency of resolution was 98.4%, with an average duration of medical attention of 30 min (SD 16.5). According to guidelines, 60.2% of the mild exacerbations were well treated, as were 26.7% of the moderate exacerbations and none of the severe episodes. Peak expiratory flow was measured in 54.5% of patients. In 82 cases (66.6%) salbutamol was given with a large-volume spacer chamber. Treatment after discharge was correct in 27.3% of the mild and 23.3% of the moderate exacerbations. A total of 23 (23.9%) patients presented more than one exacerbation during the study period., Conclusions: Most exacerbations seen in primary care are mild. Administration of salbutamol was sufficient for the resolution of these exacerbations. However, treatment after discharge was not compliant with guidelines in most cases. The primary care team was able to resolve most of the asthma exacerbations.

Objective: To describe the characteristics of the asthmatic population at our centre through the information gathered from clinical records, the morbidity caused by asthma and the health education given., Design: Retrospective, descriptive study., Setting: Urban primary care team., Participants: Asthma sufferers over 14 registered at the centre (n=284)., Main Measurements: Review of the clinical records and analysis of data on diagnosis, follow-up and control of the illness., Results: Prevalence of asthmatics at our centre ran at 1.8%. 73.6% (68.5-78.7) were women, whose average age was 51.25 (21.57). 19% were illiterate. The most common kind of asthma was intermittent (14.1%, 10-18.1). Respiratory infections sparked off acute attacks in 15% (11.3-19.7) of cases. 39.8% (31.4-45.5) (n=113) were diagnosed at the health centre. Spirometry was used as a diagnostic test in 23% (15.2-30.8) (n=26) of these 113 patients. The PC doctor participated in monitoring 81.7% (77.2-86.2) of asthma cases. Spirometry was used in the previous 3 years on 45.4% (39.6-51.2). 95% of spirometry tests were conducted at the hospital. As to health education, there was no record of explanations about the concept of asthma or of breathing techniques in 90.1% (86.1-93.4) and 81% (76.4-85.5) of clinical records, respectively., Conclusions: High percentage of asthmatics monitored by PC doctors. Under-recording in clinical records of asthma-related action taken. Few additional monitoring tests were conducted. There were few data on health education.

Aim: To determine how skilled our patients with asthma are in performing different steps in the use of different inhalation devices, and to identify variables that may influence correct inhalation technique (IT)., Design: Descriptive, cross-sectional study., Setting: An urban primary care center., Participants: 141 patients with asthma., Main Outcome Measures: Performance of a practical test to evaluate each step in IT for different devices according to SEPAR-semFYC guidelines. One point was scored for each step that was performed correctly, and the technique was considered correct if the total score was >9. The main outcome variable was the percentage of patients who performed the IT correctly., Results: About three-fourths of the participants (77.3%) were women; mean age was 56.08 +/- 18.99 years. Inhalation technique was incorrect in 53.9% of the patients (51.06% of those who used a pressurized canister inhaler, 59.1% of those who used a PCI+spacer, 38.5% of those who used a Turbuhaler, and 37.5% of those who used an Accuhaler). The highest error rates were seen in exhaling completely before beginning the inhalation (63.78%), holding the breath after inhalation for as long as possible (65.94%), and breathing out slowly after the inhalation (64.86%). Better IT was seen in younger patients with higher levels of education (P=.007). There were no statistically significant differences in the rest of the variables., Conclusions: A large percentage of patients performed inhalations incorrectly. We cannot conclude that any given device is superior. The variables related with correct IT were age and level of education. Greater health education efforts are needed to teach patients how to use inhalation systems correctly.