OBJECTIVE: To evaluate the effect of a general practice asthma clinic on morbidity, lifestyle and drug usage in patients with asthma and to compare the effect of providing written or verbal instructions. SETTING: An urban general practice in North Staffordshire. METHOD: Patients registered with the practice, with a diagnosis of asthma, were invited to attend an asthma clinic. Those who met specified criteria were randomised to receive instructions on management of their asthma either verbally (n = 25) or in written form (n = 25). On three occasions, 3 months apart, peak flow diaries were reviewed, and patients were scored according to a system designed to measure aspects of morbidity, lifestyle and drug usage. Main outcome measures were changes in the scores before and after attendance at the asthma clinic. RESULTS: Differences in the outcome measures between the verbal and written groups could not be reliably determined because of the differences between the two groups from the outset. Scores for lifestyle, nocturnal symptoms, as required bronchodilator use, other additional medication use, and highest peak flow improved by over 50% in both groups. Highest peak flow improved by 103 and 70 l/min respectively. Peak flow variability scores showed a trend towards worsening, in contrast to other measures. Significantly more preventer medication was prescribed for each patient at the end of the study compared with the preceding period. CONCLUSIONS: The use of general practice asthma clinics can reduce morbidity from asthma when existing control is poor. It is likely that this is a result of focusing attention of patients and health care professionals on basic management strategies.

Full text (sometimes free) may be available at these link(s):      help

• PDF locator
• publisher