The Impact of a Program for Control of Asthma in a Low-Income Setting

World Allergy Organization Journal

Maurício L Barreto³  Pablo Moura Santos⁴  Eduardo V Ponte⁴  Carolina Souza-Machado⁶  Rosana Franco⁵  Adelmir Souza-Machado²  Alvaro A Cruz¹ 

[1] ProAR-Faculdade de Medicina da Bahia (FMB), Federal University of Bahia (UFBA), and CNPq, Brazil;Instituto de Ciencias da Saude, UFBA, Brazil;Institute for Collective Health (ISC), UFBA, Brazil;ProAR-Hospital Universitario Professor Edgar Santos, Federal University of Bahia (UFBA), Brazil;ProAR-Hospital Especializado Octavio Mangabeira, Secretaria de Saude do Estado da Bahia, Brazil;Escola de Enfermagem, UFBA, Brazil

关键词: hospitalization;    prevention;    treatment;    control;    asthma;   

Others  :  1180787
DOI  :  10.1097/WOX.0b013e3181dc3383

【 摘 要 】

The prevalence of asthma is increasing in developing countries and the burden of uncontrolled asthma affects patients, families, and the health system. This is to summarize, evaluate, and discuss previous reports on the impact of a targeted and comprehensive approach to the most severe cases of asthma in a low-income setting. A Program for Control of Asthma (ProAR) was developed in Salvador, Bahia, Brazil, prioritizing the control of severe asthma. By facilitating referrals from the public health system and providing proper multidisciplinary but simple management including education and medication, for free, the Program enrolled 2385 patients in 4 reference clinics. They are offered regular follow up and discharged back to primary health care only when asthma control can be maintained without requirement of a combination of an inhaled corticosteroid and a long-acting β2 agonist. ProAR has markedly reduced health resource utilization and decreased the rate of hospital admissions because of asthma in the entire City (2.8 million inhabitants) by 74%. Moderate to severe rhinitis was associated with lack of control of asthma. The average income of the families in the ProAR was US$2955 a year, and they spent 29% of all their income attempting to control the severe asthma of one member, a unbearable expenditure for a low-income family. The ProAR was shown to be cost-effective, reducing costs to the public health system (US$387 patient/year) and the families (US$789 patient/year). In a low-income setting of Brazil, an intervention prioritizing the control of severe asthma was feasible, effective, and reduced costs.

【 授权许可】

   
2010 World Allergy Organization; licensee BioMed Central Ltd.

【 图 表 】

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Figure 2.

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