NATIONAL ASTHMA AND PERCEPTION OF BREATHI NG SURVEY - DAILY PRACTICE ANALYSIS AMONG GENERAL-PRACTITIONERS

Several consensus and expert conferences have defined standards for di agnosis, follow-up and treatment of chronic asthma in general practice . To assess general practice of French physicians, a prospective surve y by questionnaire was conducted in May-June 1994. The main aims of th is parr of a larger study (including patient questionnaire) was to ass ess the use of the peak-flow meter, prescription of respiratory functi on tests, and the decision to initiate chronic treatment for asthma. 4 ,015 physicians, 41.8 +/- 6.7 years old age, answered the questionnair e. Half of them practiced alone and half of them worked in a group pra ctice, 58.9 per cent were from an urban area and 41.1 per cent from an rural area. Most general practices (38.3 %) looked after 10 to 20 ast hmatic patients. More than one half of physicians routinely used a pea k-flow meter for the diagnosis, only 17 per cent did not use the peak- now meter. Respiratory function tests were ordered by 50.4 p. cent of physicians once a year. The decision to initiate chronic treatment for asthma was more often based on the frequency of use of beta 2adrenerg ic drugs (32.8 %) than on chronic obstruction (29.4 %), number of asth ma attacks each month (18.5 %), nocturnal waking (13.8 %) or effort at tacks (5.6 %). The first drug chosen for chronic treatment was inhaled steroids in adults (50.5 %) and antihistaminic - antiallergic in chil dren (38.4 %). Beta 2 mimetic constituted second-line treatment with a prescription rate of 37.2 per cent in adults and 30.4 per cent in chi ldren. In general practice for chronic asthma, physicians lend to comp ly with expert recommendations more closely when they are under the ag e of 45 years.