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Asthma nurse practice: a resource-effective approach in asthma management
Department of Research and Development in Primary Care, Mjölby, Sweden.
Department of Research and Development in Primary Care, Mjölby, Sweden.
Department of Research and Development in Primary Care, Mjölby, Sweden.
Department of Research and Development in Primary Care, Mjölby, Sweden.
1999 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 93, no 8, 584-588 p.Article in journal (Refereed) Published
Abstract [en]

The objective of this study was to evaluate the efficacy of an Asthma Nurse Practice (ANP) in primary health care.

A 12-month (September 1994–August 1995) open, prospective intervention study with pre- and post-test comparisons was performed on patients with asthma treated at a primary care centre in Sweden.

Sixty-three patients with mild or moderate asthma participated and medication, structured follow-up and education in self-management at an ANP were assessed over a 12-month period.

The main outcome measures assessed were pulmonary function, eosinophil cationic protein (ECP) in serum, respiratory symptoms, patient knowledge of asthma and emergency visits.

ANP in primary health care increased patient knowledge of asthma and medication. The number of patients with nocturnal symptoms decreased significantly. Pulmonary function was improved: vital capacity (VC) 98–106, forced expiratory volume in 1 sec (FEV1) 93–100 and peak expiratory flow (PEF) 98–115% of predicted (P<0·001). Variation in PEF fell from 21 to 12% (P<0·001). ECP was significantly reduced. Visits to the emergency room were 60% fewer during the year of intervention (P<0·01).

In conclusion, patients attending an Asthma Nurse Practice, comprising a structured programme for asthma management, improve their knowledge and asthma control.

Place, publisher, year, edition, pages
1999. Vol. 93, no 8, 584-588 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-26739DOI: 10.1016/S0954-6111(99)90159-2Local ID: 11334OAI: oai:DiVA.org:liu-26739DiVA: diva2:247289
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Asthma nurse practice in primary health care: quality, costs and outcome
Open this publication in new window or tab >>Asthma nurse practice in primary health care: quality, costs and outcome
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The primary aim of the present work was to document and analyse whether it is beneficial to patients and to the health care sector to organise asthma care in primary health care is  the form of asthma nurse practices (ANPs). During the past decade ANPs have been established in primary health care in the county of Östergatland, Sweden. The prevalence of asthma is increasing in the industrialised world, and this focuses attention on the efficacy and quality of asthma care.

The methods, data collection and measurements that were used can be summarised as follows. The studies included: (i) a prospective intervention study (ANP concept) with pre- and post- test comparisons, objective measurements and patient questionnaires; (ii) further development of a patient questionnaire, validation of items by structured followHup telephone interviews using predetermined criteria; (iii) comparison of quality and cost in two different approaches to providing asthma care within primary health care, traditional care and care given at a primary health care centre with an ANP, by combining a retrospective review of documentation in patient records using a special form and a prospective approach using a patient questionnaire; (iv) semi-structured interviews with asthma patients to obtain their view of asthma care and clarify factors of importance for compliance with prescribed medication.

The evaluation demonstrated that on the group level, primary health care centres with ANPs resulted in better disease control, fewer asthma symptoms, and better patient experienced knowledge and self-management outcomes. The results also showed fewer emergency visits, better documentation of asthma management and better asthma quality outcomes. It was also found that health care costs were lower with the ANP than with traditional asthma care in primary health care. The patients expressed important aspects of the care as the need for security, including regular asthma check-ups, easy access to care, continuity in the care, competence ofthe health care staff, and information and knowledge about asthma. Increasing age, female gender, long duration of the disease, the attitude of the staff, and whether patients felt they had obtained information and education about asthma were all factors of importance for compliance with prescribed medication.

The main conclusion of the thesis was that the ANP concept seems to improve asthma care in primary health care and resulted in economic advantages for the health care sector.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2001. 69 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 695
Keyword
asthma, asthma care, primary health care, family practice, nursing, quality, costs, consensus programs, guidelines
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27512 (URN)12168 (Local ID)91-7219-989-X (ISBN)12168 (Archive number)12168 (OAI)
Public defence
2001-11-09, Administrationsbyggnadens aula, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-11-09Bibliographically approved

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Lindberg, MalouAhlner, Johan

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