Asthma is the most common chronic condition seen in primary care and creates a significant work load in both primary and secondary care. Mortality and morbidity remain unacceptably high as the majority of both are avoidable with optimal use of preventative medicines. It is not only good practice to regularly review every patient with a long-term condition, but when coupled with self-management regular reviews improve clinical outcomes. All patients with asthma should therefore have the opportunity of a review at least once a year in primary care, which should be structured, patient-centred and promote self-management with the aim to minimise symptoms and enable patients to live a normal life. This article aims to provide a pragmatic approach to performing this review as a primary care clinician.
Brocklebank, D., Ram, F., Wright, J., Barry, P., Cates, C., Davies, L.,… White, J. (2001). Comparison of the effectiveness of inhaler devices in asthma and chronic obstructive airways disease: A systematic review of the literature. Health Technology Assessment, 5(26), 1–149. doi: 10.3310/hta5260.
3.
BTS/SIGN. (2012). British guideline on the management of asthma. A national clinical guideline. Retrieved from www.brit-thoracic.org.uk/guidelines-and-quality-standards/asthma-guideline.
4.
Clark, N. M., Gong, M., Schork, M. A., Evans, D., Roloff, D., Hurwitz, M.,… Mellins, R.B. (1998). Impact of education for physicians on patient outcomes. Pediatrics, 101(5), 831–836. doi: 10.1542/peds.101.5.831.
5.
Feder, G., Griffiths, C., Highton, C., Eldridge, S., Spence, M., & Southgate, L. (1995). Do clinical guidelines introduced with practice based education improve care of asthmatic and diabetic patients? A randomised controlled trial in general practices in east London. British Medical Journal, 311(7018), 1473–1478. doi: 10.1136/bmj.311.7018.1473.
6.
Gibson, P. G., Powell, H., Coughlan, J., Wilson, A. J., Abramson, M., Haywood, P.,… Walters, E. H. (2003). Self-management education and regular practitioner review for adults with asthma. Cochrane Database of Systematic Reviews, 1, art. no. 001117. doi: 10.1002/14651858.cd001117.
Gruffydd-JonesK.NicholsonI.BestL.ConnellE. (1999) Asthma in general practice. Why don't patients attend the asthma clinic?Asthma in General Practice7: 36–39.
9.
Haughney, J., Price, D., Kaplan, A., Chrystyn, H., Horne, R., May, N.,… Bjermer, L. (2008). Achieving asthma control in practice: Understanding the reasons for poor control. Respiratory Medicine, 102(12), 1681–1693. doi:10.1016/j.rmed.2008.08.003.
Pearson, M. G., & Bucknall, C. E. (1999). Measuring clinical outcome in asthma: A patient focused approach. London, UK: Royal College of Physicians.
12.
PinnockH.AdlemL.GaskinS.HarrisJ.SnellgroveC.SheikhA. (2007) Accessibility, clinical effectiveness, and practice costs of providing a telephone option for routine asthma reviews: Phase IV controlled implementation study. British Journal of General Practice57(542): 714–722.
13.
Pinnock, H., Fletcher, M., Holmes, S., Keeley, D., Leyshon, J., Price, D.,… Wagstaff, B. (2010). Setting the standard for routine asthma consultations: A discussion of the aims, process and outcomes of reviewing people with asthma in primary care. Primary Care Respiratory Journal, 19(1), 75–83. doi: 10.4104/pcrj.2010.00006.
14.
Powell, H., & Gibson, P. G. (2003). Options for self-management education for adults with asthma. Cochrane Database of Systematic Reviews, 1, art. no,004107. doi: 10.1002/14651858.cd004107.
