Acute severe asthma: Factors that influence hospital referral by the general practitioner and self-referral by the patient

Arnold, A.G.; Lane, D J; Zapata, Eva

doi:10.1016/0007-0971(83)90005-0

Cited by 26 publications

(3 citation statements)

References 15 publications

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“…In Southampton junior casualty officers, as in many other hospitals in the United Kingdom, are divided equally between those on surgical rotations and those in general practitioner vocational training schemes. They receive formal instruction on the management of common conditions such as asthma, and this is reinforced with a typed protocol displayed in the accident and emergency department describing the management of 1) A significant seasonal variation was found, with the maximum number of attendances in November (22) and the minimum in July (5) (p < 0.01). More patients attended at the weekend, with 47% of patients presenting between midnight Friday and midnight Sunday, compared with the expected value of 29% if attendance had been uniform (p < 0.001).…”

mentioning

confidence: 99%

Assessment and management of asthma in an accident and emergency department.

Reed¹,

Diggle²,

Cushley³

et al. 1985

Thorax

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Patients with asthma presenting to the accident and emergency department at Southampton General Hospital during 12 months were reviewed retrospectively to determine how many patients attended, when and how patients were assessed and treated, and what factors appeared to influence whether a patient was admitted to a medical ward or not. Thirty five visits were made by patients requesting a repeat prescription for a metered dose inhaler. A further 193 visits were made by 152 patients (93 male, 59 female); only data on the first visit of any individual were analysed in this study. Patients were more likely to visit in the autumn, at the weekend, and in the evenings. Observations and measurements used to assess the severity of asthma were recorded with variable frequency-heart rate in 84% of examinations, pulsus paradoxus in 13%, and peak flow rate in 11%. Blood pressure was five times more likely to be recorded than peak flow rate. The drugs used to treat asthma were, in order of frequency, a ,B agonist (120 patients), intravenous aminophylline (39), and intravenous corticosteroids (30). Sixty (39%) of the patients were admitted to a medical ward. Admission was more likely to occur when patients arrived during the week than at the weekend, when they had cyanosis or pulsus paradoxus, and after receiving parenteral treatment.

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confidence: 99%

Assessment and management of asthma in an accident and emergency department.

Reed¹,

Diggle²,

Cushley³

et al. 1985

Thorax

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“…The trial outcome measures were selected to be representative of primary care asthma management, ie, control is gauged by the incidence of asthma attacks, how patients feel (their symptoms) and PFR measurements 24 . Asthma attacks or episodes of non‐infective respiratory breakdowns are a valid measure and have been used in other practice‐ and hospital‐based studies 25 , 26 …”

Section: Discussionmentioning

confidence: 99%

A Double‐bund Placebo‐controlled Trial of Theophylline in General Practice

Neville

Crombie

McDevitt

1991

Int J Clinical Practice

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SUMMARY Patients with moderate to severe asthma, from two urban general practices, entered a double‐blind randomised placebo‐controlled crossover trial of sustained‐release theophylline versus placebo. Theophylline was given in therapeutic dosage (to ensure serum levels of between 10 and 20 μg/ml) for two months, followed by two months of placebo or vice versa. The results from the 24 patients who entered both theophylline and placebo treatment arms were compared, using outcome measures relevant to general practice care. Theophylline is shown to be of value in the management of asthma in general practice.

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“…2 Rates of admission for acute asthma appear to be rising 3 and asthma represents a major proportion of acute medical admissions. 4,5 Previous studies have originated from secondary care, and were often single centre-based and focused on either adult or paediatric populations. 6,7 There is, therefore, a need for a study based in primary care, where the majority of asthma sufferers receive most of their care, 8 covering the whole of the UK and encompassing all age groups.…”

Section: Introductionmentioning

confidence: 99%