Abstract
Introduction
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.
Methods
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.
Results
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% (pConclusions
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.
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.
Methods
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.
Results
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% (pConclusions
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.
| Original language | English |
|---|---|
| Article number | 21 |
| Number of pages | 7 |
| Journal | npj Primary Care Respiratory Medicine |
| Volume | 33 |
| Early online date | 2 May 2023 |
| DOIs | |
| Publication status | Published - 13 May 2023 |
Bibliographical note
Funding:This project was funded with a grant from the British Lung Foundation (BLF) which has since been rebranded as Asthma + Lung UK. Initial funding was allocated to the three CCGs and Optimum Patient Care Limited (OPC). OPC assisted this project with additional in kind support. The views expressed in this manuscript are those of the author(s) and not necessarily those of the funders.
Acknowledgments:
This project is based in part/wholly on data from the Optimum Patient Care Research Database (opcrd.co.uk) obtained under licence from Optimum Patient Care Limited (OPC) and its execution is approved by recognised experts affiliated to the Respiratory Effectiveness Group. However, the interpretation and conclusion contained in this report are those of the author/s alone. We would like to acknowledge Francis Appiagyei and Victoria Carter from OPC for their role in development and delivery of the OPC/BLF QI reports and their support to DP in this publication.