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Audits cut asthma workload by a third

Audits of asthma care can cut GP workload caused by the condition by almost a third in a year, reveals a study in 77 practices.

Urgent consultations, acute attacks and reported symptoms all fell significantly after GPs were told how they compared with other practices on asthma patients' symptoms, medication, acute episodes and resource use.

Practices received individual feedback telling them how well they were meeting the standards set out in the British Thoracic Society national asthma guidelines.

The study, which covered 1,339 patients, found the proportion needing an urgent consultation fell from 47 to 33 per cent between the first and second year of audit.

The number of acute episodes fell from 307 to 217 and the proportion of patients reporting symptoms during a GP consultation dropped from 52 to 38 per cent.

Some 56 per cent of patients had a self-management plan in year two of the study compared with 44 per cent in the first year, according to results presented by researchers from the Tayside Centre for General Practice at the European Respiratory Society annual conference last month.

A second study presented to the conference, by the General Practice Airways Group, found the proportion of patients using peak flow meters rose from 48 to 79 per cent over six months in 11 practices given audit and feedback. Use of self-management plans also rose from 11 to 27 per cent.

Professor Martyn Partridge, immediate past-chair of the British Thoracic Society and professor of respiratory medicine at Imperial College in London, said there was 'very strong' evidence that audit improved asthma care.

He queried the omission of self-management plans from the quality and outcomes framework. 'There are 36 randomised controlled trials showing self-management improves care of asthma, yet only 3 per cent of UK patients report having personal written asthma care plans,' he said.

Dr Gaylor Hoskins, leader of the Tayside study and research fellow in general practice at the University of Dun-dee, said: 'Audit does work ­ it's not the total answer but if you get good feedback based on guidelines, practices are

encouraged on their own results to change the way they work.'

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