Differences in asthma management between white European and Indian subcontinent ethnic groups living in socioeconomically deprived areas in the Birmingham (UK) conurbation
Department of
Thoracic Medicine, City Hospital NHS Trust, Birmingham B18 7QH, UK
Correspondence to: Dr H Moudgil.
Received 12 August 1997; Returned to authors 27 October 1997; Revised version received 24 February 1998; Accepted for publication 27 February 1998
BACKGROUND
Hospital admission rates for asthma
have been higher for Asian (Indian subcontinent, ISC) ethnic minority
groups in the UK than for white Europeans (W/E). As this may in part be
due to differences in the uptake or delivery of preventative health
care strategies, the extent to which targeted education and treatment programmes reach these groups needs to be determined.
METHODSSix hundred and eighty nine
asthmatic subjects (345 W/E, 344 ISC) of mean (SD) age 34.5 (15) years
(range 11-59) and mean forced expiratory volume in one second
(FEV1) 80% predicted from districts of high ethnicity and
socioeconomic deprivation within inner city Birmingham were reviewed in
the appropriate dialect (English, Punjabi, Hindi, Urdu) in a community
based study.
RESULTSData adjusted for age and analysed
separately for men (M) and women (F) showed no significant differences
in the numbers reporting previous asthma education, assessment of
delivery techniques, or being taught about medications, but there were
significant differences for advice on trigger factors (M: 52% vs 42%;
F: 56% vs 42%), recognition of symptoms (M: 51% vs 43%; F: 53% vs
33%), and ownership of peak flow meters (M: 35% vs 22%; F: 36% vs
24%) for W/E and ISC groups, respectively. Anti-inflammatory asthma medications were highly prescribed, but self reported drug compliance (M: 73% vs 62%), understanding medications (F: 59% vs 39%), and self management (F: 23% vs 12%) varied significantly. Asthma follow up in the community was low for both groups with more of the ISC subjects also being followed up by hospital.
CONCLUSIONSThe management of both ethnic groups
has centred on drug prescription, delivery techniques and compliance,
but has been deficient, particularly in the ISC group, in developing
understanding of the disease and self management.
© 1998 by Thorax
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