Abstract 2

An audit of the views held by primary and secondary asthma care givers and parents, identified that asthma reviews were incordinated and communication poor. General practitioners were concerned that their pivotal role was not appreciated and 30% of parents preferred to attend paediatrician alone. In response to this a Shared Care Programme (SCP) was piloted in North & West Belfast, involving 11 general practices. Shared Care guidelines were developed along with parent held treatment and record cards. The outcome of this SCP was audited along with views of the GPs and parents. At present 70 children with severe asthma are enrolled in the programme, 27 having completed more than 18 months. The parents of 21 of these children along with a GP from each practice completed questionnaires. The number of emergency attendances reduced from an average of 2.5 per patient per year to 1. The overall number of planned attendances remained the same but fewer patients required more than 4 visits (8/21 vs 4/21). There was no change in the number of courses of antibiotics but there was marked increase in use of systemic steroids. Following introduction of the SCP the number of children routinely attending the GP rose from 13 to 17. 69% of GPs considered SCP improved patient management, and 54% felt communication had improved. This pilot SCP was successful in improving patient management while reducing the total number of attendances at GP and paediatric clinics. The keystone to its success was the commonly agreed guidelines with all parties respecting the expertise of both GP and Paediatrician.