Primary care based clinics for asthma.

Area of Science:

• Pulmonary Medicine
• Primary Care Management
• Clinical Trials

Background:

• Asthma prevalence is rising globally, particularly in high-income countries.
• Primary care asthma clinics offer proactive, nurse-led care with organized patient recall.
• Evidence supporting the effectiveness of these specialized asthma clinics is limited.

Purpose of the Study:

• To evaluate the effectiveness of organized asthma care delivered through primary care-based asthma clinics.
• To synthesize evidence from randomized controlled trials on asthma clinic interventions.

Main Methods:

• Searched the Cochrane Airways Group Specialised Register and reference lists for relevant trials.
• Included randomized controlled trials comparing primary care asthma clinics with usual general practitioner care.
• Two independent reviewers assessed trial eligibility, extracted data, and resolved disagreements.

Main Results:

• Three studies with 466 participants were included; most outcomes showed no significant difference between clinic and usual care groups.
• Wide confidence intervals and heterogeneity were noted for exacerbations and work absenteeism.
• A statistically significant reduction in nocturnal asthma awakenings was observed in one study (OR 0.31; 95% CI 0.12 to 0.77).

Conclusions:

• Limited evidence currently supports the efficacy of primary care-based asthma clinics.
• Further high-quality randomized controlled trials are necessary to draw firm conclusions.
• The effectiveness of these clinics for managing asthma exacerbations requiring oral steroids remains unevaluated.