Targeted routine asthma care in general practice using telephone triage.
BACKGROUND
There is a high non-attendance rate for traditional clinic-based routine asthma care in general practice. Alternative methods of providing routine asthma care need to be examined.


OBJECTIVE
To examine the cost and effectiveness of targeted routine asthma care in general practice using telephone triage, compared to usual clinic care.


METHODS
An open randomised controlled trial.


METHODS
A single semi-rural practice in the southwest of England.


METHODS
Adult patients with asthma were randomised to receive either their routine asthma care in the surgery or care by telephone triage. Asthma control parameters, health status and NHS resource utilisation were measured over the 12-month study period.


RESULTS
One hundred and ninety-four patients were randomised and 35% per cent more patients (n = 84 versus n = 62) received more than one consultation in the telephone group. Asthma control as measured by the asthma control questionnaire (ACQ) was similar in the clinic and telephone groups: mean change in ACQ = -0.11 (95% CI = -0.32 to 0.11) versus -0.18 (95% CI = -0.38 to 0.02). Mean NHS costs were 210 pounds sterling per patient per year in the telephone group compared to 334 pounds sterling in the clinic group (P-value of bootstrapped difference = 0.071).


CONCLUSIONS
Targeted routine asthma care by telephone triage of adult asthmatics can lead to more asthma patients being reviewed, at less cost per patient and without loss of asthma control compared to usual routine care in the surgery.
Gruffydd-Jones
Kevin
K
University of Aberdeen. Kevin.Gruffydd-Jones@gp-J83013.nhs.uk
Hollinghurst
Sandra
S
Ward
Sabbi
S
Taylor
Gordon
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000191:economics / Q000628:therapy*; D017046:Cost Savings; D004739:England; D005194:Family Practice / Q000191:economics / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019114:Remote Consultation / Q000191:economics / Q000458:organization & administration*; D012423:Rural Health; D013689:Telephone; D014218:Triage / Q000191:economics / Q000458:organization & administration*