The impact of ethnicity on asthma care

If these inhalers contain alcohol, how can they be used by Muslim asthma patients?

Ethnic considerations in asthma diagnosis and care are quite complex.  We are still unclear as to the relative contribution of environment and genes leading to episodes of asthma or wheeze; however, we do know that ethnic minority groups experience disproportionate burden with respect to care and treatment.  For example, many inhaler treatments contain alcohol which are not appropriate courses of treatment for Muslim asthma patients, or patients who prefer alcohol free treatments (see paper).  Alternative medicines are available, however, this would require physicians to diagnosis and treat in culturally competent ways.  One easy way of achieving culturally competency is to listen.

Below is an abstract for a paper we published exploring these and other issues in asthma care relating to ethnicity.  Please e-mail me or comment for copies of the paper.

Reference:

Davidson E, Liu JJ & Sheikh A.  The impact of ethnicity on asthma care.  Primary Care Respiratory Journal, 2010; 19(3):202-208

Alrasbi M & Sheikh A.  Alcohol-based pressurised metered-dose inhalers for use in asthma:  a descriptive study, Primary Care Respiratory Journal, 2008; 17:111-113.

Abstract
Asthma is a significant global health problem. Asthma prevalence, its related health outcomes, and associated healthcare utilisation, vary by population group both across and within nations. Evidence of ethnic variations in the prevalence and outcomes of asthma within nations have been well documented. This review examines the impact of ethnicity on asthma, with a focus on the literature from the UK and the USA. Explanations for the unequal burden of disease experienced by ethnic minority groups include: their health beliefs, attitudes, experiences and behaviours; the problem of poor health literacy, which tends to compound the challenges inherent in cross-cultural communication; concerns about the quality of care; and the relatively poor socio-economic position of minority ethnic groups and how this impacts on the wider determinants of health. We conclude by suggesting research priorities for asthma and ethnicity, along with practical actions within a collaborative care model.

Keywords
Asthma, ethnicity, disease burden, outcomes, morbidity, mortality, health beliefs, quality of care, cross-cultural communication, collaborative care

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