Asthma deaths ‘may have been avoided’

Press, 5 February 1987, Page 26

Asthma deaths ‘may have been avoided’

PA Dunedin Death may have been avoided in about 70 per cent of deaths from asthma between 1981 and 1983, according to an article in the latest "New Zealand Medical Journal”. The study, described in the article, found that several factors contribute to death in many cases, including poor drug compliance, ending of medical care, and delay in seeking help in the final attack by patients or relatives. From the medical side, the article identified poor long-term care with regard to drugs and educa- • tion, poor access to care, and delay in attendance during the final attack as other factors which contributed to deaths of asthmatics. The study analysed the circumstances surrounding all . deaths from asthma in New Zealanders under 70 years of age, between August 1981 and July 1983. Lack of follow-up medicalxare and a reluctance.;®

on the part of doctors to prescribe steroids to treat serious asthma could also have played a part in the deaths of some patients. The study used information recorded or recalled by doctors or relatives of the deceased. It found for almost half the 271 deaths medical help had not been called before the patient was at the point of death. When medical help was summoned in sufficient time doctors commonly did not give steroids or used them inadequately. Delay in seeking medical . help was commonly found in families or patients with poor use of long-term medical care. Many of these patients attended hospital casualty departments or saw their family doctors only during attacks, and did not seek help at other times. Difficulties in using medical care and noncompliance were more common among Polynesians than Europeans, the study found.

In most deaths, combinations of patient and medical management deficiencies contributed to death. The study found 18 per cent of cases had died in spite of good medical care and good patient compliance, and said with current knowledge such deaths might now be preventable. But the study said the results underlined the need for doctors and other personnel to spend time informing and educating asthma patients. Asthmatic patients must be educated about longterm management, and about management of acute attacks. Attending a general practitioner between attacks was mandatoiy. The study also suggested some areas of primary health care might need to be redesigned to meet the needs of minority groups such as Polynesians, who were not getting effective treatment under the present system.