Pragmatic 'real world' study of the effect of audit of asthma on clinical outcome (original) (raw)

Neville, R.G., Hoskins, G., Mccowan, C. ORCID: https://orcid.org/0000-0002-9466-833X and Smith, B.(2004) Pragmatic 'real world' study of the effect of audit of asthma on clinical outcome.Primary Care Respiratory Journal, 13(4), pp. 198-204. (doi: 10.1016/j.pcrj.2004.06.007)

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Abstract

AIMS: To test whether participation in clinical audit is associated with improved care of a long-term health condition. METHODS: Real world study comparing 1339 patients of all ages and severity of asthma managed by 77 self-selected highly motivated general practices in Scotland with 9617 patients from 319 practices from a national sample. RESULTS: Patients managed by audit practices had more structured clinical reviews by nurses [817 (61%) versus 4301 (45%) OR 0.52, 95% CI 0.46?0.58] and less acute GP contacts [440 (33%) v 4161 (43%) OR 1.56, CI 1.38?1.56]. Consequently they experienced more checking of inhaler technique, use of peak flow meters and self- management plans. Audit patients had more symptom free days [365 (42%) v 2216 (23%) OR 0.80, CI 0.70.0.91], and fewer asthma attacks [217 (16%) v 1938 (20%) OR 1.30, CI 1.12.1.53]. They made less use of hospital services including A&E [30 (2%) v 326 (3%) OR 1.53, CI 1.03,2.28] and outpatients [42 (3%) v 459 (5%) OR 1.55, CI 1.11.2.16]. CONCLUSIONS: Patients with asthma benefit from being managed by a practice involved in a programme of audit.

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