Self-treatment of asthma: possibilities and perspectives from the practitioner's point of view

Objectives. Self-management of asthma is becoming more and more widespread. The implementation of this treatment strategy requires changes in the role and attitude of the GP. These changes may be hindered by obstacles both ex pected and experienced. As self-treatment of asthma is more common in the U K, comparison between UK and Dutch GPs provides a good opportunity to ident ify possible obstacles in general practice to the implementation of self-tr eatment of asthma with inhaled corticosteroids. Methods. We carried out a qualitative descriptive study with self-administe red questionnaires and interviews. Questionnaires were sent to 500 randomly selected Dutch GPs. Interviews were held with 20 Dutch and 25 British GPs in order to acquire more in-depth information. The outcome measures were at titude towards, knowledge regarding and experiences with self-treatment of asthma; organizational requirements; and expectations of consequences of se lf-treatment in general practice. Results. The Dutch and British GPs investigated have a positive attitude to wards self-treatment of asthma. Though knowledge about self-treatment is pr esent among a majority of the GPs, self-treatment by patients is not yet as common in The Netherlands as it is in the UK. Nineteen per cent of the Dut ch GPs had experience with, a written peak-flow-based self-treatment plan r elated to the usage of inhaled steroids. According to our findings, present expected obstacles are probably mainly of the organizational kind, such as the availability of time, money and materials. Conclusions. There is a positive attitude towards the implementation of sel f-treatment plans in general practice, but problems relating to certain ide ntified obstacles need to be addressed. There is a need to define which pat ients might profit from self-treatment, and further proof of both the clini cal effectiveness and the cost-effectiveness of self-treatment needs to be acquired.