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Prim Care Respir J. 2004 Dec;13(4):198-204.

Pragmatic 'real world' study of the effect of audit of asthma on clinical outcome.

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  • 1Asthma Research Unit, Tayside Centre for General Practice, University of Dundee, Kirsty Semple Way, Dundee DD2 4BF, UK.



To test whether participation in clinical audit is associated with improved care of a long-term health condition.


'Real world' study comparing 1339 patients of all ages and severity of asthma managed by 77 self-selected highly motivated general practices in Scotland with 9617 patients from 319 practices from a national sample.


Patients managed by 'audit' practices had more structured clinical reviews by nurses [817 (61%) versus 4301 (45%) OR 0.52, 95% CI 0.46-0.58] and less acute GP contacts [440 (33%) v 4161 (43%) OR 1.56, CI 1.38-1.56]. Consequently they experienced more checking of inhaler technique, use of peak flow meters and self- management plans. 'Audit' patients had more symptom free days [365 (42%) v 2216 (23%) OR 0.80, CI 0.70-0.91], and fewer asthma attacks [217 (16%) v 1938 (20%) OR 1.30, CI 1.12-1.53]. They made less use of hospital services including A&E [30 (2%) v 326 (3%) OR 1.53, CI 1.03-2.28] and outpatients [42 (3%) v 459 (5%) OR 1.55, CI 1.11-2.16].


Patients with asthma benefit from being managed by a practice involved in a programme of audit.

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