Health seeking behaviour and care provided to obstructive airway disease patients in Trivandrum, South India

Introduction: Patients with obstructive airway diseases, COPD and Asthma are often not diagnosed or managed as per guidelines in India Aims and Objectives: To determine the proportion of patients with COPD and Asthma in Trivandrum, South India whose diagnosis and treatment were as per GOLD/GINA guidelines and to determine the health seeking behaviour of these patients Methods: A hospital based cross-sectional study was done at two tertiary care hospitals among patients with a diagnosis of COPD or Asthma. The tests done for their diagnosis at the centres where they were previously treated and the treatment offered at the peripheral centre was determined. Patients were also interviewed to determine where they sought treatment before they came to the tertiary care centre and what was the diagnosis told to them Results: The study included 190 patients, 157 Asthma and 33 COPD. The initial care sought by the patients was - 49% approached government sector (48% approached private sector), 91% from doctors practicing modern medicine (9% from doctors prescribing alternate systems) and 60% from a postgraduate doctor. Only 10% of patients were told that they had “Asthma” and 3% that they had “COPD”. 69% of patients with Asthma and 86% of COPD were not told the name of their disease. Only 15% of patients had undergone a spirometry before they reached the tertiary care centre. 79 (42%) patients were prescribed an inhaled medication by the treating doctor before (s)he reached the study centre, of which 26% were using it regularly as advised and 16% had a good inhaler technique Conclusions: Low proportion of patients with COPD and Asthma were properly educated, diagnosed or treated in South India