Guidelines For Better Management Of Asthma By Family Doctors

07 Apr 2002

Asthma patients, both adults and children, can now benefit from a new set of Clinical Practice Guidelines (CPG) that will help their family doctors further improve the management of their conditions. Based on current best clinical evidence, the guidelines are tailored to suit our local context. Targeted at GPs and polyclinic doctors, the guidelines include specific action plans covering the various aspects of asthma management, including drug treatment and patient education. The handbook also touches on the latest anti-asthma drugs and includes a section on management of environmental triggers, with recommendations derived from local medical research on house dust mites and environmental pollutants.

Published by the Ministry of Health, the handbook also features a new self-assessment section of 15 multiple choice questions to help doctors evaluate whether they have mastered the key concepts of the guidelines.

As part of the Ministry's continual efforts to update existing CPGs, the section on management of asthma in children has been revised from the 1998 CPG on Paediatric Asthma. The new guidelines will help ensure good quality and cost-effective care for asthma patients in Singapore.

Importance of Proper Management of Asthma

Asthma is a common problem which is estimated to affect about 20% of our children and 5% of adults. The number of asthma cases in children has doubled over the last 15-20 years. Asthma, together with bronchitis and emphysema, accounted for 7 out of every 1,000 deaths in Singapore for the year 2000. The high personal and socio-economic burden of asthma marks it out as an important public health problem, for which active measures must be taken to further improve clinical care and outcomes.

Efforts to Improve Asthma Care in Singapore

A recent Asthma Insights and Reality in Asia Pacific (AIRAP) study conducted in Singapore and the Asia Pacific region has found that asthma is often under-detected, under-treated and its disease severity under-perceived. To address this, the Ministry of Health launched the National Asthma Shared Care Programme (NASCP) in May 2001 to help doctors provide better care for asthma patients. In addition, the programme features partnerships between the Health Promotion Board (HPB), polyclinics, general practitioners and restructured hospitals, to enhance public understanding of asthma and its treatment, and the need for good long-term control of the condition in individual patients.

Under the NASCP, the MOH initiated a programme involving the five restructured hospitals and KK Women?s & Children?s Hospital which seeks to optimise the care of patients with more severe asthma, to prevent frequent emergency room visits, hospitalisations, and asthma deaths. This programme is funded as part of the MOH?s Health Services Development Programme (HSDP). The HPB has also made intensive efforts to raise public awareness on asthma and its treatment. It has recently produced a new set of educational booklets on asthma for members of the public and asthma patients which emphasise self-management and preventive strategies.