Researchers investigate the differences in asthma management and severity between different ethnic groups in Britain, in order to improve services to all groups.
One million children receive treatment for asthma in the United Kingdom. Healthcare practitioners have noticed a difference in asthma management between children of different ethnicities. Children of South Asian heritage were experiencing more morbidity (the asthma was more disabling) and had higher hospital admission rates than white British children. This study was structured to understand the perceptions and experiences of asthma management in British South Asian and white British families. In doing so, the researchers hoped to locate any cultural causes for barriers in management.
Dr. Lakhanpaul and colleagues performed the study and published it in BMC Pulmonary Medicine. To accomplish this study, the researchers prepared a questionnaire and asked the questions in the form of a semi-structured interview. The British South Asian participants of the survey consisted of 30 families that came from six major South Asian ethnic-religious groups. The answers of these families were documented and then compared to answers given by 17 white British families. The focus of the questions was on daily management and communication with healthcare providers. Through these replies, the researchers analysed the perceived quality of health services.
There were many similarities between ethnic groups with regards to the causes and difficulties experienced by the families of children with asthma. All reported a limited understanding of the origins of asthma and were uninformed about treatment strategies and the use of medications. None of the families had received an asthma plan. Both groups equally reported diagnosis and treatment delays, and many experienced what was perceived as uncoordinated care and inconsistent advice from health professionals.
There seemed to be an increased communication barrier between the health professionals and the British South Asian parents of asthma patients. A wider family involvement was also noticed and documented among the South Asian families. The results regarding the enquiry of why a high number of South Asian patients presented to the emergency department pointed to reasons that were related to the patients’ previous visit to the hospital. Some of the issues encountered were the hardship in accessing primary care along with the lack of awareness regarding other alternatives. Additionally, further concern was raised due to the difficulties experienced by parents to assess the severity of the asthma attack.
The results of this study have indicated that despite the discrepancies in number, ineffective management of asthma attacks has causes that are seen on the level of the hospital, community, and individual. The researchers conclude by stating the need for culturally sensitive, holistic, and collaboratively designed interventions. Communication between the healthcare system and the patient increases awareness, and therefore barriers to language should be addressed. Regardless of the ethnicity of the patient, it is the right of the patient to receive an asthma plan by the health staff at the hospital. Provisions to ensure parents are well informed about the use of medications, asthma triggers, assessment of asthma severity, and accessing help should be verified.
Written by Dr. Apollina Sharma, MBBS, GradDip EXMD
Reference: Lakhanpaul, M., Culley, L., Robertson, N., Bird, D., Hudson, N., Johal, N., … & Manikam, L. (2017). A qualitative study to identify parents’ perceptions of and barriers to asthma management in children from South Asian and White British families. BMC Pulmonary Medicine, 17(1), 126.