Black and South Asian people with asthma are at increased risk of hospital admission from acute attacks than white patients. Researchers in this week's BMJ find that different ways of coping with asthma among this group may act as barriers to good care, and they suggest ways in which such barriers can be overcome and admission rates reduced.
In collaboration with general practices in east London, researchers based at the University of London interviewed 58 south Asian and white adults with asthma (49 admitted to hospital with asthma, 9 not admitted) and 25 health professionals about influences on hospital admission.
They found that south Asian patients admitted to hospital with asthma had less confidence in controlling their asthma, were unfamiliar with the concept of preventive medication, and often expressed less confidence in their general practitioners than white patients. Furthermore, patients reporting difficulty in accessing primary care during asthma attacks were often south Asian.
These findings could reflect either specific cultural characteristics or the difficulties of coping with asthma in deprived social circumstances where racism is common and health services are often inadequate and inappropriate, say the authors.
Interventions that increase confidence to control asthma, confidence in the general practitioner, understanding of preventive treatment, and use of appropriate medication during asthma attacks may reduce hospital admissions, say the authors. Development of more sophisticated and culturally competent asthma strategies by general practices with better access and partnerships with patients may also achieve this, they conclude.