@article {Burney:January 2008:1027-3719:13,
	author = "Burney, P.",
	author = "Potts, J.",
	author = "Ait-Khaled, N.",
	author = "Sepulveda, R.M.D.",
	author = "Zidouni, N.",
	author = "Benali, R.",
	author = "Jerray, M.",
	author = "Musa, O.A.A.",
	author = "El-Sony, A.",
	author = "Behbehani, N.",
	author = "El-Sharif, N.",
	author = "Mohammad, Y.",
	author = "Khouri, A.",
	author = "Paralija, B.",
	author = "Eiser, N.",
	author = "Fitzgerald, M.",
	author = "Abu-Laban, R.",
	title = "A multinational study of treatment failures in asthma management",
	journal = "The International Journal of Tuberculosis and Lung Disease",
	volume = "12",
	year = "January 2008",
	abstract = "SETTING: Emergency rooms.<P></P>OBJECTIVE: To assess quality of care and its determinants for asthma patients before emergency room treatment.<P></P>DESIGN: Consecutive patients with acute severe asthma attending emergency rooms were questioned about the severity of their disease and treatment in the previous 4 weeks. Prescriptions of inhaled corticosteroids were recorded. Other outcomes included self-reported adherence to treatment and loss of work.<P></P>RESULTS: Thirteen centres in 11 countries recruited 1156 patients. Only 36% of patients with persistent asthma had been prescribed an adequate dose of inhaled corticosteroids. This percentage improved in those receiving regular care from the same doctor (OR 2.86, 95%CI 1.38-5.96), and was at least as good for the 10% of patients receiving `private' health care (OR 3.08, 95%CI 1.69-5.62). Forty-four per cent of patients had health insurance covering some asthma medications. These patients were more likely to be receiving adequate inhaled corticosteroids (OR 1.74, 95%CI 1.17-2.58), and reported better adherence than those without insurance (OR 3.00, 95%CI 1.64-5.50). Of those on adequate inhaled corticosteroids, 18% had lost work in each of the 4 previous weeks compared with 59% among those more than one treatment step below the recommended dose.<P></P>CONCLUSIONS: Access to adequate treatment is critical for better management of asthma.",
	pages = "13-18(6)",
	url = "http://www.ingentaconnect.com/content/iuatld/ijtld/2008/00000012/00000001/art00005"
}