Systematic review on how primary healthcare workers in LMICs obtain information for prescribing (5)

4 February, 2019

Dear Siân,

Thank you for your message indicating underuse of inhaled steroids and overuse of short-acting beta-agonists.

You note: "IPCRG groups in four high income countries (Spain, Portugal, Canada and UK) have been leading "Asthma Right Care" conversations with patients, prescribers, dispensers (pharmacists) and other health care professionals to explore the reasons and they are fascinating and plentiful."

It would be interesting to hear more about the reasons and to compare the situation in LMICs.

One possible reason that comes to mind is that beta-agonists are much more likely to give immediate relief, while the impact of inhaled steroids is preventive of episodes in subsequent hours, days and weeks. In the minds of patients (and perhaps many health workers) this will lead to a misperception that beta-agonists are more effective the steroids.

With reference to your general statement: "Of course primary care access to information about medicines and correct use do not necessarily follow", this is quite right. Reliable information on how to prescribe correctly is, however, a prerequisite for correct prescribing. A prerequisite, though often not sufficient.

Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org