Chronic obstructive airway diseases: ls the EDL sufficient? A study done at the Heidedal CHC in Bloemfontein.

Abstract

Background: With the implementation of the Standard Treatment Guidelines (STG's) and Essential Drug List (EDL) in 1996 some of the traditional medication for the treatment of asthma and chronic obstructive pulmonary disease (COPD) were removed from the medication list, e.g. slow release oral theophylline. The objective of this study was to establish whether we were able to treat patients with chronic obstructive airway disease (which includes asthma and chronic obstructed pulmonary disease) effectively with the guidelines and medication on the Standard Treatment Guidelines and Essential Drug List for Primary Health Care (STGI and EDL), 1996. Method: In this follow-up study all patients with chronic obstructive airway diseases (COAD) at Heidedal Community Health Center (CHC) over a 3-month period were evaluated and a lung function test was done on them. Their old medication was stopped and the treatment guidelines of the STG's and EDL were followed.A repeat lung function test was done on all patients after three months on the new treatment. Four indicators were used namely: FVC, FEV I , FEFmax and FEF25-75. Results: Fifty patients were included in the study. Improvement in all four lung functions were noted after the new guidelines were implemented. Conclusions: The implementation of the EDL guidelines for asthma and COPD controlled the diseases, the guidelines were easy to use and are comparable to the latest international standards. Standard guidelines also create better patient compliance and give confidence to health workers. The revised STGI and EDL for Primary Health Care (1998) are comparable with the guidelines used in this study.