Introduction Occupational asthma (OA) accounts for 1 in 6 cases of adult-onset asthma and is associated with an estimated societal cost in the UK of £100 million/annum.1 However many workers with OA go undiagnosed or experience a lengthy delay in diagnosis,2 and primary healthcare professionals fail to enquire about patients’ occupations and the effect of work on asthma symptoms.3 We evaluated the feasibility of introducing an electronic screening tool for OA in primary care.
Methods A prospective feasibility study was undertaken over a 3-month period in 4 primary care practices in Birmingham, UK. Practices modified their existing electronic health records (one of: EMIS, SystmOne, Vision) with a customised asthma review template embedding the questions “What is your occupation?” and “Are your symptoms better away from work on days away/on holiday?” Baseline practice-level data were gathered and at the end of the study period all exposed healthcare professionals (GPs, practice nurses) were invited to complete an online questionnaire intended to evaluate utility and willingness to use the tool.
Results Prevalence of Read-coded asthma was 5.6–8.2% and Read-coded OA was 0–0.7%. All 4 practices incorporated the screening tool without any technical difficulty. 24/52 (46%) exposed GPs/nurses returned questionnaires, of whom 10 (42%) had used the tool; uptake was higher (85%) in those professionals who were given brief training. Healthcare professionals who did use the screening tool found it to be user-friendly (clear, concise, logical) with no perceived procedural or IT difficulties or significant added burden. Responders were less confident (44% agreed/strongly agreed) about how to act when patients had work-related asthma symptoms and 78% agreed/strongly agreed that further training in managing health aspects of suspected occupational asthma would improve the screening tool.
Conclusion An electronic screening tool for OA can be easily and quickly incorporated into existing asthma disease management systems. Its utility could be greatly improved by user instruction and training in further clinical management of the patient with work related asthma symptoms.
Ayres et al. Thorax 2011;66(2):128–33
Fishwick et al. PRCJ 2007;16:304–10
Walters et al. Occup Med 2012;62:570–3
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