It's good to talk ... ... but do I really need to see you? : The potential of telephone consultations for providing routine asthma care

The British Thoracic Society / Scottish Intercollegiate Guideline Network (BTS/SIGN) British Guideline on Asthma Management advocates a regular, structured review for all patients with asthma.1 This seems reasonable. Regular review has been linked with improved asthma morbidity.2 As clinicians we have a professional responsibility as well as compelling medicolegal reasons to review patients for whom we are prescribing. Theoretically, therefore, we should welcome the inclusion of routine asthma reviews as a quality indicator in the new UK General Medical Services (GMS) Contract.3

In practice, however, people with asthma are reluctant to attend for asthma reviews.4 Despite over a decade of proactive asthma care in general practice only about a third of patients are seen each year for a routine review. 4,5 Anecdotally, this contrasts with relatively high attendance at diabetic and coronary heart disease clinics (over 90% in my practice). We know that asthma affects quality of life4 but perhaps it is not sufficiently inconvenient, or not perceived as sufficiently serious, to warrant the investment of time and effort involved in attending a clinic review. If we are to achieve the 70% target set by the GMS Contract we will need to think outside the four walls of our surgeries.