Results of a national asthma campaign survey of primary care in Scotland.
OBJECTIVE
To identify within primary care in Scotland how far procedures for asthma review and patient education match guideline recommendations.


METHODS
Telephone survey of a one in four stratified random sample of all 1058 general practices in Scotland.


METHODS
Practice nurses, general practitioners.


METHODS
Number of practices matching guideline recommendations for asthma review, targeting of care, use of structured asthma records, provision of management plans, education, and regular audit.


RESULTS
Of 276 general practices contacted 91% (251) completed the questionnaire; 93% (228) ran an asthma review service; 74% (166) employed a specially trained asthma nurse; 39% (106) had a policy for providing action plans; 63% (155) had carried out an asthma audit in the previous 3 years; 76% (218) used a structured tool in consultations, 46% with use of computer technology, 34% used only a manual stamp. Sixty-six per cent (173) had searched for patients overusing beta2 agonists; 32% (79) had searched for patients on medication treatment step 3 and above. Single- or two-partner practices were less likely to follow guideline recommendations but neither rurality nor deprivation was related to guideline compliance.


CONCLUSIONS
Three-quarters of Scottish general practices have trained asthma nurses and offer patients asthma review, but only a minority have proactive care procedures for targeting patients or a policy for providing patients with action plans. Practice systems are underused for identifying 'at-risk' patients. There is a need for proactive procedures and provision of self-management materials to patients. Access to trained asthma nurses needs to be improved.
Hoskins
Gaylor
G
Department of Medicine and Therapeutics, University of Aberdeen, Aberdeen, UK. g.hoskins@chs.dundee.ac.uk
McCowan
Colin
C
Donnan
Peter T
PT
Friend
James A R
JA
Osman
Liesl M
LM
D001249:Asthma / Q000628:therapy*; D001291:Attitude of Health Personnel; D002648:Child; D002662:Child Health Services / Q000592:standards*; D005194:Family Practice / Q000592:standards*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards*; D017064:Process Assessment, Health Care; D012606:Scotland; D011795:Surveys and Questionnaires