Abstract
Introduction:
This inner city practice has a high prevalence of smoking and a decision was made to develop the asthma clinic which had been nurse-led into a respiratory clinic attended by a doctor and nurse with spirometry at the heart of each consultation.
Methods:
The audit involved a review of computer records of all patients seen in the first year of the clinic.
Results:
One hundred and fourteen patients were seen with 50% of these being reviewed at a subsequent date. There was a DNA rate of 1.8 patients per clinic. Thirty-two patients were children and were audited separately. 71% of adult patients were smokers. 84% had inhaler technique checks documented and 84% were using spacer devices.
Influenza vaccination was administered in 79% of those in whom it was indicated, but this proportion was only 59% in the case of pneumococcal vaccination.
The diagnosis was modified after spirometry in 54% of cases. Medication was rationalised in most cases with, in particular, 29 patients with COPD having their steroids discontinued after evaluation. The use of aminophylline, oral β-2-agonists and nebulisers was also addressed and reduced where possible.
Cost effectiveness improved with a 14% reduction in prescribing costs for respiratory conditions during the period.
Conclusion:
It is possible to improve diagnosis and treatment of respiratory conditions using spiromtry in a clinic setting.
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O'Shea, E. An Audit of a Respiratory Clinic in an Inner City Practice. Prim Care Respir J 10, 75 (2001). https://doi.org/10.1038/pcrj.2001.27
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DOI: https://doi.org/10.1038/pcrj.2001.27