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Practices without asthma clinic 'less likely to prescribe inhaled steroids'

Practices without asthma clinics are 'much less likely' to follow national guidelines on treating the condition, according to a major study.

The findings, from Government-funded research, have led GP respiratory experts to urge practices unable to set up clinics to improve care by holding regular patient reviews.

Clinic access 'significantly' reduced acute attacks in the 31 per cent of practice patients with severe asthma ­ defined in the study as more than 12 attacks per year ­ researchers from the National Primary Care Research and Development Centre based at the University of Manchester found.

Practices with clinics also offered 'significantly higher' prescribing quality based on ratio of inhaled corticosteroid to bronchodilator drugs.

The study did not show asthma clinics improved symptoms for patients with moderate or mild asthma. But researchers said many such

patients had probably seen their asthma improve from severe through good management in clinics.

The study examined asthma care and prescribing patterns at 60 practices across 10 former health authorities; 663 patients with asthma at the practices were also questioned about their condition.

Asthma prevalence was 15 and 16 per cent in males and females respectively, according to the study due out in Journal of Public Health Medicine (September).

Study leader Professor Deborah Baker said GPs were 'definitely not' wasting money on asthma clinics. 'Where there was a clinic in a practice, as opposed to other forms of asthma care, they were much more likely to follow the British Thoracic Society guidelines,' said Professor Baker, professor of public health at the University of Salford.

General Practice Airways Group member Dr David Bellamy said setting up asthma clinics was now difficult due to lack of funding and guidance.

But Dr Bellamy, a GP in Bournemouth, added: 'What really matters in asthma care is whether you have a formal system of reviewing patients, whether you do that in a formal clinic or opportunistically.'

He urged GPs to review patients regularly according to disease severity and educate them on inhaler technique.

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