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

Abstract

Context: The General Practice Airways Group (GPIAG) Acute Asthma Professional Development Plan aims to improve care in line with current Guidelines. 4 general practices, 2 Out-of-Hours services and 2 nurse-run Walk-In Centres were recruited to this pilot study.
The problem: Baseline audit data was provided by 7 centres. Critical event analysis of 160 attacks suggested that guidelines for assessment and treatment were not always followed: 77(48%) had a peak flow recorded, 48(30%) were given emergency bronchodilation, 61(38%) were given systemic steroids. Equipment was not available in all centres: 2(29%) had no oxygen, 4(57%) had no soluble prednisolone, 10% of consulting rooms had no peak flow meter.
Strategy for change: The results of the baseline audit were fed back to practices prior to multi-disciplinary educational sessions at the GPIAG Congress. Organisations were encouraged to formulate their own development plans: one organisation introduced proforma for the management of acute asthma, one commissioned in-service training for staff. One practice withdrew, and illness prevented 2 delegates attending the Congress.
Effects of change: The 6 month follow up audit suggests organisational improvements: increased availability of soluble prednisolone and peak flow meters but oxygen is still unavailable.
Conclusion: There is a need to improve the management of acute asthma in primary care. This initiative has been well received: the audit protocols have proved to be practical in all three settings, innovation has been facilitated and processes of care have been improved. The need for flexibility in the provision of educational initiatives became apparent.
Funding: GPIAG

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Citations should be made in the following way:
H. Pinnock, G. Hoskins, B. Smith, T. Weller, D. Price (Aberdeen, Dundee, Warwick, Norwich, United Kingdom). Acute asthma management in primary care: a quality improvement initiative. Eur Respir J 2002; 20: Suppl. 38, 590

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