Abstract
Background:
Professional development requires practitioners to identify sub-optimal practice, and develop plans to improve care. The General Practice Airways Group (GPIAG) acute asthma development programme aims to facilitate this process.
Method:
We invited 59 GP practices, in Grampian, Scotland, to participate. We randomised consenting practices to intervention and control groups. Data about practice organisation and the management at baseline of all the acute attacks occurring over 3 months (excluding children <5yrs) were collected retrospectively from the records. Audit results were fed back to intervention practices, who attended a workshop and were encouraged to formulate a development plan. Progress was assessed by a follow up audit at 6m
Results:
23 practices were randomised: 11 to intervention. Baseline demography and organisation were similar. The intervention group recorded 54 acute attacks at baseline (B) and 62 at 6 months (6m). After the workshop, intervention practices identified availability of peak flow (PF) meters and provision of self management plans as key areas for development At 6m more GPs in the intervention group had a PF meter (B: 17/39 (44%) vs 6m: 33/38 (87%) p=<0.001) and more attacks had a PF assessment (B: 26/54 48% vs 6m: 49/62 79% p=<0.001) Post exacerbation arrangements improved, including follow up advice given to more patients (B: 22/54 41% vs 6m: 47/62 76% p=<0.001) and more patients were given a Self Management Plan (B: 6/54 11% vs 6m: 17/62 27% p=0.028). No significant improvements occurred in the control group
Conclusion:
In line with their stated intentions for development the intervention practices improved the objective assessment of attacks and improved follow up arrangements over the 6 months of the programme.
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Foster, J. Facilitation of professional development in the management of acute asthma in primary care: a randomised controlled trial. Prim Care Respir J 12, 61 (2003). https://doi.org/10.1038/pcrj.2003.21
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DOI: https://doi.org/10.1038/pcrj.2003.21