ABS65: Primary care-based asthma clinics improve detection of asthma and COPD in the population

Abstract

General practice in Sweden is mainly organised into primary health care centres (PHCCs) with defined catchment areas. Individuals with asthma and chronic obstructive pulmonary disease (COPD) are treated in primary care. Half of PHCCs in the study region have asthma clinics. The evidence shows limited benefit from primary care based asthma clinics and nurse-led managementin COPDinrandomised controlled trials. Swedish GPs register a code for the cause of the consultation; this code can be used for measuring a clinical period prevalence. To evaluate if primary care based asthma clinics facilitate detection of obstructive lung disease in the population. Subjects and method: A cross-sectional questionnaire in a Mid-Swedish region with 216 primary health care centres. The organisation of PHCCs with or without asthma clinics were compared with the proportions of persons with a coded asthma or COPD visit. Differences between PHCCs were calculated with non-parametric tests, for a linear regression model logarithmic values were used. Reliable codes were extracted from 137 centres. The PHCCs with asthma clinics coded more individuals with both asthma and COPD in the population as compared with centres without such clinics. In a regression model adherence to the coding system and fulfilment of criteria for a complete asthma clinic improved the detection rate of asthma. PHCCs with asthma clinics had seen a larger proportion of their catchment population with obstructive lung disease. Thus primary care based asthma clinics facilitate detection of asthma and COPD in the general population. Detection rate could serve as an independent measure of quality of care in General Practice. Conflict of interest and funding None.