Setting the standard for routine asthma consultations: a discussion of the aims, process and outcomes of reviewing people with asthma in primary care

Hilary Pinnock, Monica Fletcher, Steve Holmes, Duncan Keeley, Jane Leyshon, David Price, Richard Russell, Jenny Versnel, Bronwen Wagstaff

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Globally, asthma morbidity remains unacceptably high. If outcomes are to be improved, it is crucial that routine review consultations in primary care are performed to a high standard. Key components of a review include: * Assessment of control using specific morbidity questions to elucidate the presence of symptoms, in conjunction with the frequency of use of short-acting bronchodilators and any recent history of acute attacks * After consideration of the diagnosis, and an assessment of compliance, inhaler technique, smoking status, triggers, and rhinitis, identification of poor control should result in a step-up of treatment in accordance with evidence-based guideline recommendations * Discussion should address understanding of the condition, patient-centred management goals and attitudes to regular treatment, and should include personalised self-management education Regular review of people with asthma coupled with provision of self-management education improves outcomes. Underpinned by a theoretical framework integrating professional reviews and patient self-care we discuss the practical barriers to implementing guided selfmanagement in routine clinical practice.
Original languageEnglish
Pages (from-to)75-83
Number of pages9
JournalPrimary Care Respiratory Journal
Volume19
Issue number1
Early online date29 Jan 2010
DOIs
Publication statusPublished - Mar 2010

Keywords

  • asthma
  • bronchodilator agents
  • evidence-based practice
  • humans
  • medication adherence
  • patient acceptance of health care
  • patient education as topic
  • physician-patient relations
  • practice guidelines as topic
  • primary health care
  • risk factors
  • primary care
  • guided self-management
  • monitoring long-term conditions
  • asthma action plan

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