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Randomised controlled trial of general practice based asthma clinics
A R Heard1, I J Richards, J H Alpers
1SA HealthPlus, Department of Human Services, Adelaide. Adrian.Hearda@dhs.sa.gov.au
The Medical Journal of Australia
|September 4, 1999
Summary
Asthma clinics in general practice did not significantly reduce asthma morbidity compared to standard care. While some symptoms improved, overall outcomes were similar, suggesting other factors may influence asthma management.
Area of Science:
- Respiratory Medicine
- General Practice
- Health Services Research
Background:
- Asthma remains a significant public health concern, necessitating effective management strategies within primary care settings.
- General practice serves as the frontline for managing chronic conditions like asthma.
Purpose of the Study:
- To evaluate the effectiveness of dedicated asthma clinics within general practice compared to usual care for reducing asthma morbidity.
- To assess the impact of structured asthma management interventions on patient outcomes.
Main Methods:
- A randomized controlled trial was conducted across eight general practices.
- 195 patients (aged 5-64) with asthma participated, with 191 completing the study.
- The intervention involved three asthma clinic sessions over six months, including nurse counseling, education, spirometry, and GP consultation.
Main Results:
- Asthma clinics showed a greater reduction in nocturnal asthma symptoms and increased peak flow meter ownership.
- A concerning increase in smoking initiation or resumption was observed in the intervention group.
- Both groups demonstrated similar improvements in work/school days lost, symptom presence, action plan use, and reliever medication adherence.
Conclusions:
- The study did not find evidence that asthma clinics are superior to standard general practice care in reducing asthma morbidity.
- The observed improvements may be influenced by the study's presence, natural patient recovery, or other confounding factors.
- Further research is needed to clarify the specific benefits and optimal implementation of asthma clinics in primary care.
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