Assessment of asthma control: an audit of clinical practice

Introduction Despite the development of international guidelines for the management of asthma, epidemiological surveys suggest that control of the disease remains poor. In order to investigate clinical practice a postal questionnaire was used to study the evaluation of asthma control, the assessment of factors associated with poor control and the impact of tools to measure asthma control. Methods 12,000 questionnaires were mailed to 10,000 general practitioners (GP) and 2000 French specialists. Results The response rate was 13 and 31% for GP and specialists respectively. 44% of specialists and 9% of GPs declared that they made a systematic assessment of nocturnal symptoms, R-2 agonist usage and peak flow, 32% of the specialists and 15% of the GP's declared a systematic search for poor compliance, inhaler technique and the avoidance of trigger factors. 77% of the GP's and 43% of the specialists had never used a questionnaire for asthma control. Conclusion Available tools for the systematic evaluation of asthma control are rarely used and both asthma control itself and factors known to be associated with it are insufficiently monitored. The impact of the implementation in the medical community of a more systematic and pragmatic approach should be evaluated.