Pragmatic 'real world' study of the effect of audit of asthma on clinical outcome

Citation

Neville RG, Hoskins G, McCowan C & 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. https://doi.org/10.1016/j.pcrj.2004.06.007

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.

Journal
Primary Care Respiratory Journal: Volume 13, Issue 4