Setting the standard for routine asthma consultations: a discussion of the aims, process and outcomes of reviewing people with asthma in primary care.
Globally, asthma morbidity remains unacceptably high. If outcomes are to be improved, it is crucial that routine review consultations in primary care are performed to a high standard. Key components of a review include: * Assessment of control using specific morbidity questions to elucidate the presence of symptoms, in conjunction with the frequency of use of short-acting bronchodilators and any recent history of acute attacks * After consideration of the diagnosis, and an assessment of compliance, inhaler technique, smoking status, triggers, and rhinitis, identification of poor control should result in a step-up of treatment in accordance with evidence-based guideline recommendations * Discussion should address understanding of the condition, patient-centred management goals and attitudes to regular treatment, and should include personalised self-management education Regular review of people with asthma coupled with provision of self-management education improves outcomes. Underpinned by a theoretical framework integrating professional reviews and patient self-care we discuss the practical barriers to implementing guided selfmanagement in routine clinical practice.
Pinnock
Hilary
H
Senior Clinical Research Fellow, Allergy and Respiratory Research Group, Centre of Population Health Sciences: GP Section, University of Edinburgh, Scotland, UK. hilary.pinnock@ed.ac.uk
Fletcher
Monica
M
Holmes
Steve
S
Keeley
Duncan
D
Leyshon
Jane
J
Price
David
D
Russell
Richard
R
Versnel
Jenny
J
Wagstaff
Bronwen
B
D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D055317:Evidence-Based Practice; D006801:Humans; D055118:Medication Adherence; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000379:methods*; D012307:Risk Factors
D001993:Bronchodilator Agents