Primary health care centres with asthma clinics: effects on patients' knowledge and asthma control

Abstract

Aim: To evaluate outcomes for patients attending primary care centres with and without asthma clinics. Methods:A cross-sectional survey at 42 primary health care centres randomly selected according to organisation of asthma care, 14 with complete, 14 with incomplete and 14 with no asthma clinic according to national criteria. 1,477 randomly selected patients 15-45 years received two questionnaires. Outcomes were: patients' knowledge of asthma; asthma control; and quality of life.Results: Patients attending primary health care centres with asthma clinics reported more knowledge of asthma but similar levels of asthma control and quality of life. Patients who reported they had visited the asthma nurse during the last year had more knowledge but similar asthma control and quality of life compared to patients who reported they had not. However, with more time allocated for the nurse, 44% achieved asthma control compared with 27% at asthma clinics with less time (p<0.003). Conclusions:Having an asthma clinic at a primary health care centre improves asthma patients' knowledge of the disease, and better asthma control is achieved if the nurse is allocated more time.

Planned primary health care asthma contacts during 12-year follow-up after Finnish National Asthma Programme: focus on spirometry

“…In our study, spirometry, peak flow monitoring or both was performed in almost every planned contact if patient encountered both nurse and GP. This suggests that planned asthma follow-up contact may benefit from the involvement of both professionals 50 . In a Danish study 29 , planned asthma management by both nurse and doctor participating with systematic approach improved asthma control.…”

Experiences of living with asthma – a focus group study with adolescents and parents of children with asthma

“…Nurses as educators can generate significant reductions in the cost for asthma care, for example through decreased emergency department visits and improved self-management of asthma exacerbations (124). Having access to an asthma nurse in primary care in Sweden and internationally has been shown to increase patient knowledge, improve asthma control and reduce costs (125)(126)(127).…”

Adherence to national guidelines for children with asthma at primary health centres in Sweden: potential for improvement

“…These findings are not consistent with other reports showing that access to an asthma nurse in primary care improves knowledge about and control of the disease, as well as quality of life. 11,13 In addition, a Dutch study showed that care provided by a specialised asthma nurse is as effective in the outpatient management of stable childhood asthma as traditional management by a paediatrician or GP. 43 Furthermore, attention to clinical guidelines can improve evidence-based nursing practice in connection with the non-pharmacological management necessary for optimal treatment of childhood asthma in which specialised asthma nurses are highly skilled.…”

“…9,10 Factors reported to facilitate asthma control include the use of a spirometer and access to a specialised asthma nurse. 11,12 Having access to an asthma nurse has been shown to increase patients' knowledge, improve asthma care, and reduce costs. 13 In several fields of medicine, many patients fail to achieve the goals set by evidence-based guidelines [14][15][16][17] and, for adults with asthma, adherence to guidelines in primary care has been reported to be poor.…”