Journal of Public Health

, Volume 24, Issue 1, pp 21–29 | Cite as

The characteristics of diagnosis, patient care and education of asthma and COPD patients from the perspective of the actors in the Hungarian healthcare system

  • Alpár Horváth
  • Ágnes Jókay
  • Árpád Farkas
  • Gábor Tomisa
Original Article

Abstract

Aim

In our study, we wanted to assess the workload under which health professionals work with asthmatic and COPD patients, the average time spent on investigation, patient care, patient education and on checking their previously acquired knowledge. We also wanted to know who educates these patients to the proper use of inhalation devices and how often they check their usage.

Subject and methods

We have conducted personal interviews and online surveys among health professionals. We made distinguished time spent on “freshly” diagnosed patients, routine control examinations and previously diagnosed patients. Participants: asthma nurses from the pulmonary care network, hospital departments, specialized practices and pulmonary care units; pulmonologists; specialists from internal medicine departments and emergency health care centres and GPs (general practitioners).

Results

Our results show that in every group of healthcare professionals involved in the treatment of these patients, the number of daily meetings between healthcare professionals and patients is remarkably high (an average of 30 patients a day), and there is not enough time for patient education. Checking the proper usage of the device is often skipped and no appropriate educational materials are available.

Conclusions

Patients are not likely to have sufficient knowledge of their disease or the appropriate usage of their inhalation devices. Reorganization of the Hungarian COPD and asthmatic patient care system is needed as soon as possible to provide effective patient education and patient care.

Keywords

Patient education Asthma Chronic obstructive pulmonary disease Use of inhalation devices Patient care Patient examination and education time 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Abdulwadud O, Abramson M, Forbes A, James A, Walter EH (1999) Evaluation of a randomised controlled trial of adult asthma education in a hospital setting. Thorax 54:493–500CrossRefPubMedPubMedCentralGoogle Scholar
  2. Accordini S, Corsico AG, Braggion M, Gerbase MW, Gislason D, Gulsvik A, Heinrich J, Janson C, Jarvis D, Jögi R, Pin I, Schoefer Y, Bugiani M, Cazzoletti L, Cerveri I, Marcon A, de Marco R (2013) The cost of persistent asthma in Europe: an international population-based study in adults. Int Arch Allergy Immunol 160:93–101CrossRefPubMedGoogle Scholar
  3. Ágh T, Inotai A, Mészáros Á (2011) Factors associated with medication adherence in patients with chronic obstructive pulmonary disease. Respiration 82:328–334CrossRefPubMedGoogle Scholar
  4. Bender BG, Bender SE (2005) Patient-identified barriers to asthma treatment adherence: responses to interviews, focus groups, and questionnaires. Immunol Allergy Clin N Am 25:107–130CrossRefGoogle Scholar
  5. Bezerédyné HM, Hentz A, Zalányi S (1967) Secular struggle for the Hungarian healthcare (in Hungarian). Közgazdasági és Jogi Könyvkiadó, Budapest Google Scholar
  6. Csoma ZS, Antus B, Barta I, Szalay CS, Felne SA, Herjavecz I (2013) Severe asthma database in Hungary, initial steps. Clin Transpl Allergy 3:33CrossRefGoogle Scholar
  7. Dóczy V, Mészáros Á (2013) Adherence, methodology and studies in Hungary. Acta Pharm Hung 83:13–27PubMedGoogle Scholar
  8. Espinoza-Palma T, Zamorano A, Arancibia F, Bustos MF, Silva MJ, Cardenas C, De La Barra P, Puente V, Cerda J, Castro-Rodriguez JA, Prado F (2009) Effectiveness of asthma education with and without a self-management plan in hospitalized children. J Asthma 46:906–910. doi:10.3109/02770900903199979 CrossRefPubMedGoogle Scholar
  9. ESzCSM 32/2004 (IV.26.) (2004) The Hungarian regulation about the prescription of subsidized medications. The Ministry of Health, Budapest. Available at: http://www.oep.hu/felso_menu/szakmai_oldalak/gyogyszer_segedeszkoz_gyogyfurdo_tamogatas/egeszsegugyi_vallalkozasoknak/pupha/Vegleges_PUPHA.html. Accessed 28 Aug 2015
  10. Herjavecz I, Boszormenyi NGY, Gyurkovits K, Magyar P, Dobos K, Nagy L, Alemao E, Ben-Joseph R (2003) Cost, morbidity and control of asthma in Hungary: the Hunair study. J Asthma 40:673–681Google Scholar
  11. Korányi National Institute of Tuberculosis and Pulmonology (2014) Korányi Bulletin. Available at: http://www.koranyi.hu/tartalom/bulletin/Evkonyv2014.pdf. Accessed 20 May 2015
  12. Krasznai É (2014) Status and future of the Hungarian general practitioner supply with focus on pediatric care (in Hungarian). Orvosok Lapja 12:32–35 http://www.weborvos.hu/adat/files/2015_januar/ol12.pdf. Accessed 29 Aug 2015
  13. Matsui DM (1997) Drug compliance in pediatrics: clinical and research issues. Pediatr Clin N Am 44:1–14CrossRefGoogle Scholar
  14. McPherson A, Glazebrook C, Smyth A (2001) Double click for health: the role of multimedia in asthma education. Arch Dis Child 85:447–449CrossRefPubMedPubMedCentralGoogle Scholar
  15. Peters SP, Ferguson G, Deniz Y, Reisner C (2006) Uncontrolled asthma: a review of prevalence, disease burden and options for treatment. Respir Med 100:1139–1151CrossRefPubMedGoogle Scholar
  16. R Core Team (2015) Statistical software: the R project for statistical computing. http://cran.r-project.org/manuals.html. Accessed 20 May 2015
  17. Rand CS, Wise RA (1994) Measuring adherence to asthma medication regimens. Am J Respir Crit Care Med 149:S69–S76CrossRefPubMedGoogle Scholar
  18. Simon J (2013) Attitudes of Hungarian asthmatic and COPD patients affecting disease control: empirical research based on Health Belief Model. Front Pharmacol 4:135. doi:10.3389/fphar.2013.00135 CrossRefPubMedPubMedCentralGoogle Scholar
  19. Szentes T, Vályi-Nagy I (2015) Restructuring the healthcare system: redesigning based on needs. Orv Hetil 156:83–91CrossRefPubMedGoogle Scholar
  20. The Global Initiative for Chronic Obstructive Lung Disease. GOLD (2015) Global strategy for diagnosis, management, and prevention of COPD. http://www.goldcopd.org/guidelines-global-strategy-for-diagnosis-management.html. Accessed 20 May 2015
  21. The Organisation for Economic Co-operation and Development OECD (2013) Health at a glance 2013. http://www.oecd.org/els/health-systems/Health-at-a-Glance-2013.pdf. Accessed 20 May 2015
  22. Thoonen BP, Schermer TR, Van Den Boom G, Molema J, Folgering H, Akkermans RP, Grol R, Van Weel C, Van Schayck CP (2003) Self-management of asthma in general practice, asthma control and quality of life: a randomised controlled trial. Thorax 58:30–36CrossRefPubMedPubMedCentralGoogle Scholar
  23. Trinn CS, Molnar P (2001) Patient education in Hungary. Patient Educ Couns 44:71–74CrossRefPubMedGoogle Scholar
  24. Virchow JC, Crompton GK, Dal Negro R, Pedersen S, Magnan A, Seidenberg J, Barnes PJ (2008) Importance of inhaler devices in the management of airway disease. Respir Med 102:10–19. doi:10.1016/j.rmed.2007.07.031 CrossRefPubMedGoogle Scholar
  25. Weinstein AG (1995) Clinical management strategies to maintain drug compliance in asthmatic children. Ann Allergy Asthma Immunol 74:304–308PubMedGoogle Scholar
  26. Yoon R, McKenzie DK, Bauman A, Miles DA (1993) Controlled trial evaluation of an asthma education programme for adults. Thorax 48:1110–1116CrossRefPubMedPubMedCentralGoogle Scholar
  27. Zolnierek KB, DiMatteo MR (2009) Physician communication and patient adherence to treatment: a meta-analysis. Med Care 47:826–834CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Alpár Horváth
    • 1
  • Ágnes Jókay
    • 2
  • Árpád Farkas
    • 2
  • Gábor Tomisa
    • 1
  1. 1.Chiesi Hungary Kft.BudapestHungary
  2. 2.Centre for Energy Research, Hungarian Academy of SciencesBudapestHungary

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