Asthma management in pregnancy ‘poor’

Asthma management in pregnancy has not improved over the last decade, according to research from NSW. 

The research team from the Priority Research Centre Grow Up Well at the University of Newcastle in NSW used data from three cohorts of pregnant women with asthma recruited in 2004, 2007 and 2013.

Their study involving 895 women found self reported non-adherence to inhaled corticosteroids were similar between the cohorts, with an average adherence rate of 42 percent.

Baseline knowledge of medications, optimal inhaler technique, and the possession of a written asthma plan (WAP) was low across the cohorts, the researchers reported.

“The poor rate of WAP possession is clear evidence for the lack of adequate asthma management in the primary care setting… this could be the result of less community awareness campaigns or a poor implementation of the GP 3+ plan currently known as the ‘Asthma Cycle of Care’,” they wrote in the Journal of Asthma.

The research team also discovered that lung function had declined over time, with those in the 2013 cohort having significantly lower % predicted FEV1 and FVC compared to women in the previous studies.

“Despite national and international guidelines for asthma management in pregnancy our results demonstrate apparent poor implementation into antenatal care,” the study authors said.

However, the researchers also demonstrated that repeat education sessions during pregnancy led to  improved asthma self-management skills.

Women who attended education sessions required three sessions to optimise correct medication knowledge; two sessions for optimising inhaler technique and one session was required to lower the perceived risk of asthma medications on the fetus.

They noted that asthma medication non-adherence wasn’t just an issue in the pregnant population, and women who are non-adherent pre-pregnancy might continue their medication behaviour during pregnancy.

“Pre-pregnancy education is therefore needed to increase the proportion of women who are adherent during their first trimester,” they suggested.

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