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

Abstract

Objective: Only a third of adult asthmatics attend for an annual review despite significant morbidity. This study tests the hypothesis that a telephone review is an effective and safe alternative to face-to-face consultations.
Methods: Symptomatic asthma patients not reviewed in the previous year were recruited from four general practices and randomised to telephone or face-to-face consultation with the asthma nurse. Our primary outcome measure was the proportion of asthmatics reviewed. Other outcomes: consultation length , Juniper Mini Asthma Quality of Life Questionnaire (miniAQLQ) and Nursing Care Satisfaction Questionnaire (NCS) Results: 278 asthmatics were randomised to surgery (S: n=141) or telephone (T: n=137) assessment. Significantly more asthmatics in the telephone arm were reviewed (101 (74%) vs. 68 (48%); p<0.001). Telephone consultations were shorter (mean duration S: 21.87 (SD 6.85) vs. T: 11.19 (SD 4.79) minutes (p<0.001) and quality of life at 3 months was equivalent: miniAQLQ S: 5.22 (SD 1.14) vs. T: 5.15 (SD 1.28) p=0.69. Both groups were equally satisfied with the consultation NCS: S: 3.86 (SD 0.55) vs. T: 3.80 (SD 0.57), p=0.51. Conclusion: Telephone consultations enabled 26% (95% CI 14 to 37%, p<0.001; NNT=3.8) more asthmatics to be reviewed than surgery consultations without clinical disadvantage or loss of satisfaction. The shorter duration of telephone consultations suggests that this may be an efficient option for the routine review of asthmatics. Funding: British Lung Foundation (Grant No P00/9); Aziz Sheikh is supported by a NHS R&D National Primary Care Fellowship.

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Citations should be made in the following way:
H. Pinnock, A. Sheikh, R. Bawden, S. Proctor, S. Wolfe, J. Scullion, D. Price (Aberdeen, London, Hyde, Norwich, United Kingdom). Telephone vs. face to face consultations in the management of adult asthmatics in UK primary care: a randomised controlled trial. Eur Respir J 2002; 20: Suppl. 38, 593

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