Asthma Health Outcomes Project
Overviews of Surveyed Asthma ProgramsSeptember 2005
International Programs: Australia (cont’d)
Proactive Asthma Care in Childhood: General Practice Based Randomised Controlled Trial
University of Sydney
Canberra, ACT 2614 Australia
The objectives of the "Proactive Asthma Care in Childhood: General Practice Based Randomised Controlled Trial" were to assess the feasibility and effectiveness of a general practice based, proactive system of asthma care in children.
Researchers at the University of Sydney implemented a randomized controlled trial design with cluster sampling by general practice. The setting was a general practice in the northern region of the Australian Capital Territory. One-hundred seventy-four children with moderate to severe asthma who attended 24 general practitioners participated in the study.
The intervention consisted of a system of structured asthma care (the 3+ visit plan). The Chief Investigator gave a one-on-one academic detailing session to all general practitioners. The intervention group was asked to administer care according to the 3+Plan. The Chief Investigator instructed them in the plan and gave them a 3+Plan patient and practitioner resource kit. Intervention practitioners were prompted when a child's next 3+ visit was due. They were offered a supplementary trial information evening.
Evaluation results indicated that intervention group children had significantly more asthma related consultations, written asthma plans, and completed 3+ visit plans than control children. Intervention group children also had a mean reduction in measurements of forced expiratory volume in one second after cold air challenge of 2.6% less than control children. Intervention group children had lower emergency department attendance rates for asthma, less speech limiting wheeze than control children, were more likely to use a spacer, and had an asthma action plan. No differences occurred in number of days absent from school or symptom-free day scores.
Researchers concluded that proactive care with active recall for children with moderate to severe asthma is feasible in general practice and seems to be beneficial.
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