Spirometry training for GP's and practice nurses: is it feasible and beneficial to asthma patients?

Abstract

Aims & Rationale The aim was to examine the impact of spirometry in the management of asthma in adults and children in primary care. Although asthma management guidelines recommend spirometry, uptake has been low and standards of spirometry generally poor. We hypothesised that regular use of properly-performed and interpreted spirometry would result in better health outcomes and improved quality of care for patients, and be acceptable and cost-effective. Approaches A cluster randomised controlled trial was conducted in 40 general practices in South Australia and Tasmania during 2006-2007. 172 GPs and 560 patients (397 adults and 163 children) were enrolled. Practices were randomised to one of 2 intervention arms or to control. The intervention involved comprehensive spirometry training for GPs and practice nurses - one group received 6 hours; the other 2 hours. Outcome data was gathered using spirometry, patient questionnaires and case note review. Principal Findings Analysis to date has shown that there were no statistically significant differences in measures of quality of life between patients in the intervention groups and control patients. Further information will be presented on any improvements in patient-reported symptoms and lung function. Changes in GPs’ management of asthma and the feasibility of conducting spirometry in Australian general practice will be discussed. Some methodological difficulties will also be highlighted. Benefits to the community This study has provided valuable evidence for policy-makers and clinicians about the worth of spirometry in Australian general practice and the conditions required for fostering its use.