Changes in asthma management during the programme
| 1993 | 2004 | |
|---|---|---|
| Primary care | ||
| General practitioner | Asthma suspicion referred to specialist without lung function tests Infrequent follow up visits Prescriptions renewed without check up | Diagnosis 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 |
| Nurse | Rarely spirometry measurements made or peak flow values followed | Daily 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 | ||
| Adults | Diagnosis of asthma | Only a portion of new diagnoses |
| Most follow up visits | Follow up of severe cases only | |
| Emergency care | Part of emergency care | |
| Children | Diagnosis, treatment, follow up of all childhood asthma Inpatient treatment of acute asthma | Diagnosis of childhood asthma Treatment, follow up of preschool asthma Inpatient treatment of acute asthma |
| 1997 | 2004 | |
| Pharmacies | ||
| Asthma coordinators | No actively organised role in asthma care | Active guidance in use of preventers and relievers; guidance in inhalation technique |
| Networking with local health care | ||