Using information from asthma patients: a trial of information feedback in primary care

摘要

Objective-To test the effects of feedback of information about patients' asthma to primary care teams. Design-Patients' reports of morbidity, use of health services, and drug use on questionnaire was given to primary care teams. Randomised controlled trial with general practices as the subject of the intervention was used to test effectiveness of supplying information. Setting-Primary care in district health authority, London. Subjects-23 general practices, each of which notified at least 20 asthmatic patients aged 15-60 years for each principal. Practices were randomly allocated to an intervention group (receiving feedback of information on control of asthma) or a control group (no feedback). Intervention-Information on cards inserted in patients' medical records; booklet copies of information for team members; formal presentation to primary care teams; poster displays of data on patients in each practice. Main outcome measures-Type and frequency of asthma symptoms, use of health services, use of asthma drugs. Results-Reported morbidity at entry to the study was substantial: 45% (818) patients reported breath-lessness at least once a week. Less than half these patients were using inhaled steroids regularly. Intervention and control groups did not differ in practice or patient characteristics on entry to the study. In spite of the potential for improvement no differences were observed between the two practice groups at the end of the study-for example, breathlessness at least once a week in last six months was experienced by 36% in intervention group υ 35% in control group (t = -0.27, P<0.79); surgery attendance in last six months by 48% υ 48% (t =- 0.05, P < 0.96); regular use of inhaled steroids by 60% υ 58% (t = 0.51, P < 0.62). Conclusion-Feedback to general practitioners of information about patients' asthma does not on its own lead to change in the outcome of clinical care.