Abstract
Introduction:
Asthma is a major health priority in Australia. Many patients are not being adequately managed in primary care, despite the introduction of incentives encouraging a more comprehensive and systematic approach to care.
Aims and objectives:
To evaluate whether systematic asthma care (especially the use of recall for an asthma review) improves the quality of care and health outcomes for adult patients, and whether this is cost effective. Subjects and method: We recruited 565 patients aged 18 or over who had been diagnosed with moderate or severe asthma. They were from 40 general practices in urban and rural settings in two Australian states. We conducted a cluster randomised controlled trial, with the practice as the unit of randomisation. The intervention included: - setting up an asthma register-recall system incorporating postcard prompts;
- education of GPs and staff about their roles in systematic care, use of spirometry and the Asthma 3+ Plan.
Data was collected through patient questionnaires, spirometry, case note review, and interviews with practice staff.
Results:
Preliminary analysis revealed that 47% of patients responded to the postcard prompts and made appointments for an asthma review. Final results will be presented showing whether this resulted in any significant differences between intervention and control patients in
- quality of care – including use of spirometry, asthma action plans, education;
- clinical outcomes – including lung function, asthma on waking, days off work;
- acceptability of systematic care;
- quality of life.
Conclusions:
The trial will determine whether changes in delivery of asthma care are acceptable, feasible and effective in improving patient outcomes — and provide an evidence base for future policy initiatives.
Conflict of interest and funding
No conflicts of interest. Funded by National Health and Medical Research Council of Australia.
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Beilby, J., Holton, C., Harris, M. et al. ABS13: Systematic practice-based asthma care in the Australian setting. Prim Care Respir J 15, 188 (2006). https://doi.org/10.1016/j.pcrj.2006.04.115
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DOI: https://doi.org/10.1016/j.pcrj.2006.04.115