Table 3

‚ÄÉChanges in asthma management during the programme

19932004
Primary care
General practitionerAsthma suspicion referred to specialist without lung function tests Infrequent follow up visits Prescriptions renewed without check upDiagnosis of asthma by GP Short specialist consultation as needed Anti-inflammatory treatment started without delay Easy access to evidence based guidelines and local treatment chains Annual follow up visits
NurseRarely spirometry measurements made or peak flow values followedDaily spirometry measurements Routine guidance in peak flow measurement and use of inhalers Patient centred asthma education with written action plan Annual follow up visits
Specialist care
AdultsDiagnosis of asthmaOnly a portion of new diagnoses
Most follow up visitsFollow up of severe cases only
Emergency carePart of emergency care
ChildrenDiagnosis, treatment, follow up of all childhood asthma Inpatient treatment of acute asthmaDiagnosis of childhood asthma Treatment, follow up of preschool asthma Inpatient treatment of acute asthma
1997 2004
Pharmacies
Asthma coordinatorsNo actively organised role in asthma careActive guidance in use of preventers and relievers; guidance in inhalation technique
Networking with local health care