Unscheduled care for people with asthma in a multi-ethnic area is reduced following educational outreach programme by specialist nurses

Abstract

Question Do asthma specialist nurses reduce health service use and improve outcomes across different ethnic groups? Study design Cluster randomised controlled trial. Main results Specialist nurse intervention reduced the percentage of participants attending unscheduled care in the subsequent year compared with usual care (adjusted odds ratio with clustering 0.61, 95% CI 0.38 to 0.99). First attendance for unscheduled asthma care in the same time period was delayed by specialist nurse intervention (hazard ratio [HR] 0.73, 95% CI 0.54 to 1.00). The effect of specialist nurse intervention on time to attendance was greater in white people (HR 0.57, 95% CI 0.38 to 0.85) compared with South Asian people (HR 0.72, 95% CI 0.48 to 1.09) or other ethnicities (HR 1.29, 95% CI 0.51 to 3.22). There were no significant difference in mean rates of hospital admission between groups. Authors’ conclusions Unscheduled care for people with asthma was reduced in practices where asthma specialist nurses provided an educational outreach and clinical support programme to staff. Improved outcomes were not equally distributed among ethnic groups.