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A comparison of the respiratory care given to asthmatic and nonasthmatic children in a general practice
1Wellington School of Medicine.
Insights
Asthmatic children require more healthcare resources and consultations than nonasthmatic children. Management of respiratory illnesses in both groups primarily occurs in general practice, highlighting areas for improved asthma care.
Area of Science:
- Pediatrics
- General Practice
- Respiratory Medicine
Background:
- General practices manage the majority of respiratory illnesses in children.
- Understanding differences in management between asthmatic and nonasthmatic children is crucial for optimizing care.
Purpose of the Study:
- To compare the management of respiratory problems in asthmatic versus nonasthmatic children.
- To identify discrepancies between clinical records and parental reports regarding asthma management.
Main Methods:
- A comparative study using matched samples of 5-9 year old asthmatic and nonasthmatic children.
- Data collected through clinical record review and parental questionnaires in a suburban general practice.
Main Results:
- Asthmatic children had more frequent consultations and received more prescriptions for antibiotics and asthma-related medications.
- Significant discrepancies were found between parental reports and medical records concerning asthma diagnosis and medication use.
- Asthmatic children were not more likely to have respiratory examinations when well or use secondary services.
Conclusions:
- General practice is the primary setting for managing respiratory illnesses in both asthmatic and nonasthmatic children.
- Further research is needed on workload, continuity of care, acute management, population-based management, and communication in pediatric asthma care.
- Improving the accuracy of medical records and communication regarding asthma management is essential.
Aim:
To compare the management of respiratory problems in asthmatic and nonasthmatic children.
Method:
A comparison of recorded morbidity in clinical records with parental replies to questionnaires for random matched samples of 5 to 9 year old asthmatic and nonasthmatic children from a suburban middle class general practice over the 1990 year.
Results:
Eighty six percent of parents of asthmatic children and 75% of parents of nonasthmatic children responded. 11% of asthmatic children left the practice without giving a forwarding address. Asthmatic children consulted more often, saw more general practitioners, and were prescribed more antibiotic and asthma related drug items than nonasthmatic children. Asthmatic children were no more likely than nonasthmatic children to have their respiratory system examined at the general practice when well and no more likely to use secondary services. Fifty seven percent of asthmatic children had an asthma drug related prescription written and 22% of asthmatic children had a peak flow recording. Disagreement between records and parental report: 31% of nonasthmatic children were reported by parents to have asthma related symptoms. 31% of these children did not see a general practitioner, 31% were seen for other problems, and 38% were treated for respiratory problems but not diagnosed as asthmatic. Forty nine percent of asthmatic children were reported to be taking daily asthma medication but 38% of these children had not been prescribed their medication in the practice. Fifty one percent of asthmatic children were reported not to be taking daily asthma medication but 50% of these children had been prescribed an asthma drug in the practice.
Conclusion:
Asthmatic and nonasthmatic children have nearly all their respiratory illnesses managed in general practice. In the general practice management of asthma the issues of workload, continuity of care, acute management, practice population based management, and communication need more research.
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