Table 1 Barriers to diagnosis and treatment
Physician reported barriers to diagnosis | Physician reported barriers to successful treatment |
|---|---|
Doctors find diagnostic criteria confusing | Fear of side effects of steroids |
Insufficient consultation time for history, examination, peak flow measurement | Fear of addiction to inhalers |
Organisation of care necessitates instant diagnosis (lack of continuity of care, leads to | Excessive antibiotic use |
Organisation of care necessitates instant diagnosis (lack of continuity of care, leads to episodic approach cash payment and fee for service discourage repeat visits) | Cost of chronic medication |
Masking by respiratory tract infection and by oral bronchodilator syrup | Poor patient understanding, adherence and inhalation technique |
Stigmatised diagnosis | Passive smoke exposure in the home |
High symptom tolerance in the community | Strong community belief in emotional cause of asthma discourages medical treatment |
| Â | Doctor hopping prevents follow-up |