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Systematic care for asthma in Australian general practice: a randomised controlled trial
- Source :
- Medical Journal of Australia. 193:332-337
- Publication Year :
- 2010
- Publisher :
- AMPCo, 2010.
-
Abstract
- OBJECTIVE 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. DESIGN AND SETTING 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. PARTICIPANTS 565 adult patients of these randomly allocated practices who had doctor-diagnosed moderate to severe asthma and were taking inhaled corticosteroids. MAIN OUTCOME MEASURES Clinical asthma indicators, quality of care, acceptability of the intervention to patients, quality of life, and asthma self-management skills at baseline, 6 months and 12 months. RESULTS 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; 95% CI, 1.0-3.5; P = 0.04) for intervention group patients compared with control group patients; there was no significant difference in other indicators. CONCLUSION We found little objective evidence of improvement in patient management and outcomes resulting from a systematic model of asthma care. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12605000091606.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Rate ratio
law.invention
Young Adult
Quality of life (healthcare)
Randomized controlled trial
law
Intervention (counseling)
Health care
medicine
Humans
Cluster randomised controlled trial
Aged
Quality of Health Care
Asthma
Aged, 80 and over
business.industry
Australia
General Medicine
asthma
Middle Aged
medicine.disease
Self Care
Clinical trial
Outcome and Process Assessment, Health Care
Quality of Life
Physical therapy
systematic care
Female
Family Practice
business
Subjects
Details
- ISSN :
- 13265377 and 0025729X
- Volume :
- 193
- Database :
- OpenAIRE
- Journal :
- Medical Journal of Australia
- Accession number :
- edsair.doi.dedup.....763a5b13583b16a8e989d0ca64aa0e94