Asthma guideline use in the Caribbean Asthma carers in the Caribbean should disseminate guidelines appropriately and ensure that they are implemented, according to a recent review. Caribbean guidelines for asthma care were developed in 1997 as a joint initiative by the Global Initiative for Asthma and the Commonwealth Caribbean Medical Research Council. Since their introduction, however, the use of pharmacotherapy for the relief and control of asthma has not been examined.An international team of researchers from chronic product chronic product the University of the West Indies, St Augustine, Trinidad and Tobago, and the Hackenthorpe Medical Centre in Sheffield in the UK, examined the utilisation of inhaled medications in asthmatic patients in Trinidad, where such medication use had previously been low.Patients with physician-diagnosed asthma who had attended the chest clinic at Trinidad and Tobago''s ministry of health between July 1998 and August 2002 were included in the study. This comprised 402 people aged seven years and older.Each individual was interviewed about compliance deteriorating asthma chronic product with, understanding of and use of inhaler medication and was asked to demonstrate their inhaler technique.Overall, inhaled steroids had been prescribed to 83 per cent of the patients studied. However, most patients reported regular use of inhaled salbutamol rather than inhaled steroid. Further analysis revealed that elderly patients and children were least likely to have received a prescription for inhaled corticosteroid and were also least likely to use this form of medication when it had been prescribed. Only 33 per cent severe asthma chronic product of patients used their inhaler correctly during the demonstration. Children and the elderly were again the two subgroups who performed the worst. Yet use of a spacer device had been advised in only 19 per cent of the patients, including only 6 per cent of the elderly patients. The team also found a void between reality and patients'' beliefs about good compliance, with widespread cessation of prevention therapy when they were feeling well. Dr Pinto Pereira, from the university, and his asthma children treatment chronic product team recommend that patient
