Systematic care for asthma not shown to improve outcomes

January 01, 0001

Systematic care for asthma not shown to improve outcomes

The aim of this study was to evaluate whether systematic asthma care involving a register-recall system, postcard prompts for review, and education for general practitioners and staff in Australian general practice improves the quality of care and health outcomes for adult patients with moderate to severe asthma. It consisted of a cluster randomised controlled trial in 40 general practices in urban and rural South Australia and New South Wales over the 2 years 2004 and 2005; practices were randomly allocated to the intervention or control group. 565 adult patients of these randomly allocated practices who had doctor-diagnosed moderate to severe asthma and were taking inhaled corticosteroids participated. Although 46% of patients in the intervention group practices responded to the postcard prompts, only 32% actually attended for their asthma review.

At 12 months, there was a statistically significant difference in provision of written asthma action plans (rate ratio, 1.9) for intervention group patients compared with control group patients; there was no significant difference in other indicators.

The researchers concluded: "We found little objective evidence of improvement in patient management and outcomes resulting from a systematic model of asthma care."

Asthma appears to be a disorder struggling with EBM from many fronts.

For the full abstract, click here.

MJA 193(6):332-337, 20 September 2010
© The Medical Journal of Australia 2010
Systematic care for asthma in Australian general practice: a randomised controlled trial. Christine H Holton, Justin J Beilby, Mark F Harris, Clare E Harper, Judith G Proudfoot, Emmae N Ramsay and Richard E Ruffin. Correspondence to Christine Holton: [email protected]

Category: R. Respiratory. Keywords: systematic care, asthma, general practice, cluster randomised controlled trial, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 15 October 2010

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