Asthma is a common illness in the United Kingdom and its incidence and severity has increased in recent years. In a paper published recently in the BMJ (1) I reported the results of a first audit cycle of asthma care in Darley Dale after starting an asthma clinic in the practice. I showed that, as a result of an audit exercise undertaken before the clinic was set up and after it had been in operation for one year, significant improvements in recording of data relevant to the management of patients with asthma was obtained – the term “asthma” entered in the patient's computerised summary record, smoking history and numbers of peak expiratory flow readings recorded. However, objective improvement in patients asthma – less requirement for oral steroids and salbutamol nebulisation – could not be demonstrated. There was an improvement in the ratio average:best peak flow rate in patients who had one or more measurements pre-clinic and post-clinic (81%→ 89%), but this difference was not statistically significant. A longer period of study will be required before major clinical improvement can be demonstrated.
As a result of undertaking this audit exercise there has been renewed emphasis on prophylaxis of asthma for patients attending the clinic, greater effort made to see all patients with asthma for clinical review at least once annually, and to facilitate these activities a second clinic has been started.