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Proactive asthma care in childhood: general practice based randomised controlled trial.
Nicholas J Glasgow1, Anne-Louise Ponsonby, Rachel Yates
1Academic Unit of General Practice and Community Care, Canberra Clinical School of the University of Sydney, PO Box 254, Canberra, ACT 2614, Australia. Nicholas.Glasgow@calvary-act.com.au
BMJ (Clinical Research Ed.)
|September 23, 2003
Summary
A proactive asthma care system in general practice improved asthma management for children. This approach led to more consultations, written asthma plans, and reduced emergency visits, demonstrating its feasibility and benefits.
Area of Science:
- Pediatric respiratory medicine
- General practice and primary care
- Health services research
Background:
- Asthma management in children often relies on reactive care.
- A proactive, systematic approach integrated into general practice may improve outcomes.
- Feasibility and effectiveness of such a system require evaluation.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of a proactive, general practice-based asthma care system for children.
- To assess the impact of a structured care plan (the 3+ visit plan) with active recall on pediatric asthma management.
Main Methods:
- A randomized controlled trial using cluster sampling of general practices.
- 174 children with moderate to severe asthma participated.
- The intervention involved a structured 3+ visit plan with active patient recall.
Main Results:
- Children in the intervention group had significantly more asthma consultations, written asthma plans, and completed care plans.
- A significant reduction in forced expiratory volume in one second after cold air challenge was observed in the intervention group.
- Emergency department visits for asthma and speech-limiting wheeze were reduced in the intervention group.
Conclusions:
- A proactive asthma care system with active recall is feasible within general practice settings.
- This proactive approach demonstrates benefits for children with moderate to severe asthma.
- The findings support the integration of systematic, proactive asthma management into primary care.