title: Targeted routine asthma care in general practice using telephone triage.
abstract: 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.
authors.affiliation: University of Aberdeen. Kevin.Gruffydd-Jones@gp-J83013.nhs.uk
authors.forename: Kevin
authors.initials: K
authors.lastname: Gruffydd-Jones
authors.forename: Sandra
authors.initials: S
authors.lastname: Hollinghurst
authors.forename: Sabbi
authors.initials: S
authors.lastname: Ward
authors.forename: Gordon
authors.initials: G
authors.lastname: Taylor
mesh_terms: 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*