Guideline implementation in long term asthma management: an audit using a medication assessment tool in Selayang Hospital / Mohd Hazim Che Hasan

There are many international guidelines that are kept updated and published for references in management of asthma whether for long term asthma management or short term (acute) asthma attack. However, do the guidelines recommendation are being followed and practiced after adapted to the local practice? There is a study conducted that patients treated according to the guideline had a significantly higher overall health related quality of life than patients with non-guideline treatment. So, why not the suggestion or recommendations of guidelines are followed even though it was seen to prove superior to the conventional management of asthma? Malaysian has not update the guideline for asthma management since it was being published in 1996. In addition, there is no auditing system that can be used to evaluate asthma management in local clinical practice. In this study, medication assessment tools (MAT) was developed from internationally recognized guideline that is being used in local clinical situation to access the current practice for management of long term asthma in Malaysia. There are 18 criteria that were tested on the asthmatic patients of sample including general criteria and treatment approach, The result showed the level of adherence to the guideline used was 86.3 percent out for 73 patients. However, if the magnification was made, the reduction of current medication dose had not been made after the symptoms of asthma have been controlled and only 39.4 percent had their dose reduction following the guideline recommendation. The adherence of Medication Therapy Adherence Clinic (MTAC) to the guideline seem to be high, however, improvement needs to be made in reducing the dose once patients' asthmatic symptoms have resolved.