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Table 1 Barriers to diagnosis and treatment

From: Educational outreach to general practitioners reduces children's asthma symptoms: a cluster randomised controlled trial

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
  Doctor hopping prevents follow-up