oa Current Allergy & Clinical Immunology - Asthma : an approach to some barriers to practice in primary and rural care : review article

Volume 20 Number 2
  • ISSN : 1609-3607



Asthma is a common disease in primary rural practice, and poor adherence is often a serious problem. Examples of factors from rural primary care are described, that cause poor outcomes in chronically ill patients, including asthmatics. These include different cultural models between health practitioners and patients, language differences and communication difficulties, poor clinical rigor, denial by patients of the seriousness of their condition and its consequences, lack of finances to attend regular consultations, and lack of the appropriate drugs, equipment or knowledge at facilities.

Hugo and Couper's model of the consultation as three balls being juggled at the same time is used to illustrate the patient-centred approach. The three balls are facilitation, clinical reasoning and collaboration. It is suggested that this approach may help to alleviate some of the factors causing poor outcomes for chronic diseases in primary rural care.

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