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Improving paediatric asthma outcomes in primary health care: a randomised controlled trial
Author(s) -
Shah Smita,
Sawyer Susan M,
Toelle Brett G,
Mellis Craig M,
Peat Jennifer K,
Lagleva Marivic,
Usherwood Timothy P,
Jenkins Christine R
Publication year - 2011
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja10.11422
Subject(s) - medicine , asthma , randomized controlled trial , intervention (counseling) , physical therapy , family medicine , receipt , pediatrics , nursing , world wide web , computer science
Objective: To evaluate the effectiveness of the Practitioner Asthma Communication and Education (PACE) Australia program, an innovative communication and paediatric asthma management program for general practitioners. Design: Randomised controlled trial. Setting: General practices from two regions in metropolitan Sydney. Participants: 150 GPs, who were recruited between 2006 and 2008, and 221 children with asthma in their care. Intervention: GPs in the intervention group participated in two 3‐hour workshops, focusing on communication and education strategies to facilitate quality asthma care. Main outcome measures: Patient outcomes included receipt of a written asthma action plan (WAAP), appropriate medication use, parent days away from work, and child days away from school or child care. GP outcomes included frequency of providing a WAAP and patient education, communication and teaching behaviour, and adherence to national asthma guidelines regarding medication use. Results: More patients of GPs in the intervention group reported receipt of a WAAP (difference, 15%; 95% CI, 2% to 28%; adjusted P = 0.046). In the intervention group, children with infrequent intermittent asthma symptoms had lower use of inhaled corticosteroids (difference, 24%; 95% CI, − 43% to − 5%; P = 0.03) and long‐acting bronchodilators (difference, 19%; 95% CI, − 34% to − 5%; P = 0.02). GPs in the intervention group were more confident when communicating with patients (difference 22%; 95% CI, 3% to 40%; P = 0.03). A higher proportion of GPs in the intervention group reported providing a WAAP more than 70% of the time (difference, 23%; 95% CI, 11% to 36%; adjusted P = 0.002) and prescribing spacer devices more than 90% of the time (difference, 29%; 95% CI, 16% to 42%; adjusted P = 0.02). Conclusions: The PACE Australia program improved GPs’ asthma management practices and led to improvements in some important patient outcomes. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12607000067471.