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Implementation of a primary care asthma management quality improvement programme across 68 general practice sites
Despite national and international guidelines, asthma is frequently misdiagnosed, control is poor and unnecessary deaths are far too common. Large scale asthma management programme such as that undertaken in Finland, can improve asthma outcomes. A primary care asthma management quality improvement p...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10182354/ https://www.ncbi.nlm.nih.gov/pubmed/37179388 http://dx.doi.org/10.1038/s41533-023-00341-y |
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author | Gilchrist, Francis J. Carroll, William D. Clayton, Sadie Price, David Jarrold, Ian Small, Iain Sutton, Emma J. Lenney, Warren |
author_facet | Gilchrist, Francis J. Carroll, William D. Clayton, Sadie Price, David Jarrold, Ian Small, Iain Sutton, Emma J. Lenney, Warren |
author_sort | Gilchrist, Francis J. |
collection | PubMed |
description | Despite national and international guidelines, asthma is frequently misdiagnosed, control is poor and unnecessary deaths are far too common. Large scale asthma management programme such as that undertaken in Finland, can improve asthma outcomes. A primary care asthma management quality improvement programme was developed with the support of the British Lung Foundation (now Asthma + Lung UK) and Optimum Patient Care (OPC) Limited. It was delivered and cascaded to all relevant staff at participating practices in three Clinical Commissioning Groups. The programme focussed on improving diagnostic accuracy, management of risk and control, patient self-management and overall asthma control. Patient data were extracted by OPC for the 12 months before (baseline) and after (outcome) the intervention. In the three CCGs, 68 GP practices participated in the programme. Uptake from practices was higher in the CCG that included asthma in its incentivised quality improvement programme. Asthma outcome data were successfully extracted from 64 practices caring for 673,593 patients. Primary outcome (Royal College of Physicians Three Questions [RCP3Q]) data were available in both the baseline and outcome periods for 10,328 patients in whom good asthma control (RCP3Q = 0) increased from 36.0% to 39.2% (p < 0.001) after the intervention. The odds ratio of reporting good asthma control following the intervention was 1.15 (95% CI 1.09–1.22), p < 0.0001. This asthma management programme produced modest but highly statistically significant improvements in asthma outcomes. Key lessons learnt from this small-scale implementation will enable the methodology to be improved to maximise benefit in a larger scale role out. |
format | Online Article Text |
id | pubmed-10182354 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-101823542023-05-14 Implementation of a primary care asthma management quality improvement programme across 68 general practice sites Gilchrist, Francis J. Carroll, William D. Clayton, Sadie Price, David Jarrold, Ian Small, Iain Sutton, Emma J. Lenney, Warren NPJ Prim Care Respir Med Article Despite national and international guidelines, asthma is frequently misdiagnosed, control is poor and unnecessary deaths are far too common. Large scale asthma management programme such as that undertaken in Finland, can improve asthma outcomes. A primary care asthma management quality improvement programme was developed with the support of the British Lung Foundation (now Asthma + Lung UK) and Optimum Patient Care (OPC) Limited. It was delivered and cascaded to all relevant staff at participating practices in three Clinical Commissioning Groups. The programme focussed on improving diagnostic accuracy, management of risk and control, patient self-management and overall asthma control. Patient data were extracted by OPC for the 12 months before (baseline) and after (outcome) the intervention. In the three CCGs, 68 GP practices participated in the programme. Uptake from practices was higher in the CCG that included asthma in its incentivised quality improvement programme. Asthma outcome data were successfully extracted from 64 practices caring for 673,593 patients. Primary outcome (Royal College of Physicians Three Questions [RCP3Q]) data were available in both the baseline and outcome periods for 10,328 patients in whom good asthma control (RCP3Q = 0) increased from 36.0% to 39.2% (p < 0.001) after the intervention. The odds ratio of reporting good asthma control following the intervention was 1.15 (95% CI 1.09–1.22), p < 0.0001. This asthma management programme produced modest but highly statistically significant improvements in asthma outcomes. Key lessons learnt from this small-scale implementation will enable the methodology to be improved to maximise benefit in a larger scale role out. Nature Publishing Group UK 2023-05-13 /pmc/articles/PMC10182354/ /pubmed/37179388 http://dx.doi.org/10.1038/s41533-023-00341-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Gilchrist, Francis J. Carroll, William D. Clayton, Sadie Price, David Jarrold, Ian Small, Iain Sutton, Emma J. Lenney, Warren Implementation of a primary care asthma management quality improvement programme across 68 general practice sites |
title | Implementation of a primary care asthma management quality improvement programme across 68 general practice sites |
title_full | Implementation of a primary care asthma management quality improvement programme across 68 general practice sites |
title_fullStr | Implementation of a primary care asthma management quality improvement programme across 68 general practice sites |
title_full_unstemmed | Implementation of a primary care asthma management quality improvement programme across 68 general practice sites |
title_short | Implementation of a primary care asthma management quality improvement programme across 68 general practice sites |
title_sort | implementation of a primary care asthma management quality improvement programme across 68 general practice sites |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10182354/ https://www.ncbi.nlm.nih.gov/pubmed/37179388 http://dx.doi.org/10.1038/s41533-023-00341-y |
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