Source: Annual Congress 2002 - Asthma in primary care - Assessment and control
Disease area: Airway diseases

Abstract

Improved referrals are likely to lead to improved communication and a functioning referral system contributes to the improvement of the quality of care. Referral letters hold many advantages as a tool for audit in general practice. The purpose of this study was to develop criteria for a good asthma referral letter. Our aim was to find out essential items to be included in asthma referral; not to create a perfect referral letter. We adopted a stepwise approach. First we made a systematic search of literature since according to previous studies it is a basic step of developing audit criteria. These criteria based on the literature were discussed by expert panel. The proposed criteria list was graded and commented by physicians (n=236, response rate 75%) nationwide in Finland. The responders represented primary, secondary and tertiary health care. These groups had very similar gradings of the criteria. Most of the suggestive criteria were considered very necessary. After expert group consensus discussion the final criteria was selected. The final list includes seven administrative and twelve disease-spesific criteria (for example dyspnea, cough, wheezing, the beginning of the symptoms, smoking, occupation, known allergies, medication, other diseases, peak flow-follow up, spirometry and bronchodilatation test). These are to be used as a tool in asthma audit in three different hospital district in Finland.

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L. Tuomisto, M. Erhola, M. Kaila, R. Kauppinen, P. Brander, V. Bergman, T. Poussa, H. Puolijoki, K. Koskela (Seinäjoki, Lammi, Lappeenranta, Hyvinkää, Helsinki, Tampere, Finland). Development of audit criteria of asthma referrals; a stepwise approach. Eur Respir J 2002; 20: Suppl. 38, 589

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