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Audit, research and guideline update
Essential medicines for COPD and asthma in low and middle-income countries
  1. Yaser T Bazargani,
  2. Anthonious de Boer,
  3. Hubert G M Leufkens,
  4. Aukje K Mantel-Teeuwisse
  1. Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
  1. Correspondence to Dr Aukje K Mantel-Teeuwisse, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, PO Box 80082, 3508 TB Utrecht, The Netherlands; A.K.Mantel{at}uu.nl

Abstract

Access to medications for chronic disease management is limited in many low and middle-income countries (LMICs), resulting in suboptimal care and avoidable morbidity and mortality. We performed a survey of COPD and asthma medicines that appeared on the national essential medicines lists (NEMLs) of 32 LMICs. Nearly all countries (>90%) had assigned essential medicines for treatment of exacerbations and early stable disease stages, but not for steps 4 (22%) and 5 (6%) controlled asthma management. The number of treatment options was limited, with long-acting β2-agonists (LABA) and combination dosage forms being notably absent. Suboptimal availability of chronic respiratory disease medicines suggests that implementation of NEMLs is the main problem in clinical practice.

  • Asthma in primary care
  • COPD epidemiology

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