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Respir Med. 1998 Feb;92(2):289-91.

Improving communication between hospital and primary care increases follow-up rates for asthmatic patients following casualty attendance.

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Department of Respiratory Medicine, University Hospital, Nottingham, U.K.


Despite adequate access to primary care facilities, there is a group of patients who habitually present to hospital accident and emergency (A&E) departments when their asthma deteriorates. In Nottingham 50% of these patients are discharged from the A&E department without admission to hospital and are advised to inform and see their general practitioner (GP), but many fail to do so. We instituted a system of identifying all patients seen and discharged from our A&E department with asthma and informing their GPs and practice nurses within one working day of the event by fax. To determine whether any action had been taken following receipt of our fax, we contacted each general practice 1 month after the A&E attendance in 100 consecutive cases. Full data were available for 66 patients. Our faxes increased the notification of A&E attendances to GPs from 47 to 89%. This resulted in an increase in the number of follow-up appointments initiated by the practice, from 15 to 31. However, 29% of patients were not asked to attend for follow-up, in spite of the practice being aware of a recent A&E visit. Improving communication between hospital and general practice increases the rate of follow-up by GPs for patients with asthma who have been discharged from A&E. This has the potential to improve asthma management for this group of patients.

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