Intervention group (N=14 practices, 457 patients) | Control group (N=15 practices, 454 patients) | All practices (N=29 practice, 911 patients) | |
Practice-level characteristics | |||
Median (IQR) practice list size* | 8368 (4428) | 7892 (5770) | 8002 (4948) |
Median (IQR) Index of Multiple Deprivation score, where higher = more deprived† | 25.24 (15.08) | 16.89 (11.83) | 20.28 (14.13) |
Practice software system | |||
EMIS LV | 2 (14.3%) | 9 (60.0%) | 11 (37.9%) |
EMIS PCS | 2 (14.3%) | 2 (13.3%) | 4 (13.8%) |
VISION | 5 (35.7%) | 3 (20.0%) | 8 (27.6%) |
SystmOne | 4 (28.6%) | 1 (6.7%) | 5 (17.2%) |
Torex synergy | 1 (7.1%) | 0 | 1 (3.4%) |
Median (IQR) no. patients on asthma register* | 606.00 (213.25) | 531.00 (394.50) | 574.00 (287.00) |
Median (IQR) no. severe asthma patients identified | 65.50 (21.75) | 56.00 (38.00) | 60.00 (31.00) |
Median (IQR) no. at-risk asthma patients identified | 19.00 (36.75) | 13.00 (30.00) | 18.00 (37.00) |
Patient demographic and clinical characteristics | |||
Female gender | 287 (62.8%) | 271 (59.8%) | 558 (61.3%) |
Mean (SD) age | 46.4 (22.1) | 44.6 (21.7) | 45.5 (21.9) |
Aged <16 years | 51 (11.2%) | 56 (12.3%) | 107 (11.8%) |
Median (IQR) severity score based on no. classes of asthma medications prescribed (0-9) | 4 (2) | 4 (2) | 4 (2) |
Charlson co-morbidity index score | |||
0 | 325 (71.1%) | 321 (70.7%) | 646 (70.9%) |
1-2 | 105 (23.0%) | 98 (21.6%) | 203 (22.3%) |
3+ | 27 (5.9%) | 35 (7.7%) | 62 (6.8%) |
Smoking status | |||
Never smoked | 176 (38.5%) | 158 (34.8%) | 334 (36.7%) |
Non-smoker | 17 (3.7%) | 32 (7.1%) | 49 (5.4%) |
Ex-smoker | 118 (25.8%) | 93 (20.5%) | 211 (23.2%) |
Smoker | 95 (20.8%) | 100 (22.0%) | 195 (21.4%) |
Missing data | 51 (11.2%) | 71 (15.6%) | 122 (13.3%) |
Exacerbation-related events | |||
Moderate-severe exacerbation in past year | 293 (64.1%) | 266 (58.6%) | 559 (61.4%) |
Median (IQR) rate of moderate-severe exacerbations | 1 (2) | 1 (2) | 1 (2) |
Hospitalisation for asthma exacerbation‡ | 28 (6.1%) | 32 (7.1%) | 60 (6.6%) |
A&E attendance for asthma exacerbation‡ | 50 (10.9%) | 49 (10.8%) | 99 (10.9%) |
Out-of-hours contact for asthma exacerbation‡ | 45 (9.9%) | 36 (7.9%) | 81 (8.9%) |
Oral prednisolone course for asthma exacerbation‡ | 293 (64.1%) | 272 (59.9%) | 565 (62.0%) |
Ambulance call for asthma exacerbation | 19 (4.2%) | 19 (4.2%) | 38 (4.2%) |
Nebulised short-acting β-agonist for asthma exacerbation | 46 (10.1%) | 79 (17.4%) | 125 (13.7%) |
Other healthcare attendances | |||
Secondary care outpatient consultations for asthma | 92 (20.1%) | 91 (20.0%) | 183 (20.1%) |
Median (IQR) rate of primary care consultations for any reason | 10 (9) | 9 (10) | 9 (10) |
‘Did not attend’ (DNAs) at primary care consultation for any reason | 84 (18.4%) | 109 (24.1%) | 193 (21.2%) |
Other asthma medications | |||
Median (IQR) rate of short-acting β-agonist inhalers prescribed | 7 (9) | 8 (11) | 7 (11) |
Median (IQR) BDP-equivalent μg/day dose of inhaled corticosteroids prescribed | 723 (986) | 657 (986) | 685 (986) |
Median (IQR) rate of long-acting β-agonist inhalers prescribed | 8 (7) | 6 (9) | 7 (8) |
Leukotreine receptor antagonists prescribed | 101 (22.1%) | 125 (27.5%) | 226 (24.8%) |
Theophyllines prescribed | 27 (5.9%) | 42 (9.3%) | 69 (7.6%) |
Data are N (%) and reported at patient-level unless otherwise indicated.
↵* Source: QOF0708_Pracs_Prevalence.xls spreadsheet via http://www.ic.nhs.uk/statistics-and-data-collections/audits-and-performance/the-quality-and-outcomes-framework/the-quality-and-outcomes-framework-2007-08.
↵† Source: Norfolk Deprivation data 2007 provided by NHS Norfolk, see: http://www.norfolkinsight.org.uk/deprivation for further information.
↵‡ Event included in count of exacerbations (see methods for full definition).