Management of asthma in Australian general practice: care is still not in line with clinical practice guidelines.
OBJECTIVE
We investigated the quality of primary care asthma management in a sample of Australian general practices.


METHODS
247 general practitioners (GPs) from 97 practices completed a structured interview about management of asthma, diabetes and hypertension/heart disease. A further structured interview with the senior practice principal and practice manager was used to collect information about practice capacity for chronic disease management.


RESULTS
Just under half of GPs (47%) had access to an asthma register and the majority (76%) had access to spirometry in their practice. In terms of routine management of asthma, 12% of GPs reported using spirometry routinely, 13% routinely reviewed written asthma action plans, 27% routinely provided education about trigger factors, 30% routinely reviewed inhaler technique, 24% routinely assessed asthma severity, and 29% routinely assessed physical activity. Practice characteristics such as practice size (p=1.0) and locality (rural/metropolitan) (p=0.7) did not predict quality of asthma management nor did indicators of practice capacity including Business maturity, IT/IM maturity, Multidisciplinary teamwork, and Clinical linkages.


CONCLUSIONS
Gaps remain in the provision of evidence-based care for patients with asthma in general practice. Markers of practice capacity measured here were not associated with guideline-based respiratory care within practices.
Barton
Christopher
C
Department of General Practice, University of Adelaide, North Terrace, Adelaide, South Australia, 5005, Australia. christopher.barton@adelaide.edu.au
Proudfoot
Judith
J
Amoroso
Cheryl
C
Ramsay
Emmae
E
Holton
Christine
C
Bubner
Tanya
T
Harris
Mark
M
Beilby
Justin
J
D001249:Asthma / Q000628:therapy*; D001315:Australia; D005194:Family Practice; D019983:Guideline Adherence; D006801:Humans; D007407:Interviews as Topic; D017410:Practice Guidelines as Topic; D011320:Primary Health Care