A comparison of asthma care by general practitioners and practice nurses and their communication with community pharmacists in Ireland
K. N. Buckley, S. A. Ryder
It is estimated by the Global Initiative for Asthma
(GINA) that Ireland has the fourth highest prevalence of asthma
worldwide. The objectives of this study were to compare the current
state of asthma management among patients as estimated by their
general practitioners (GPs) and practice nurses, to explore the frequency
of patient counselling on a variety of asthma management
issues, and to compare the communication frequency between these
practitioners and community pharmacists.
Materials & Methods:
Two anonymous postal questionnaires for
self-completion (one for GPs and one for practice nurses) were distributed
to every general practice surgery listed in the Irish classified
telephone directory in January 2011. To increase the response rate a
reminder letter was posted five weeks later. Responses were coded
and analysed using SPSS v.16.
29% of GPs and 19% of nurses responded to the survey.
Overall, a greater proportion of GPs than nurses believed that their
patients had good asthma management and a good understanding of
asthma and their medications (p<0.01, chi-squared test, in each case). Of 15
asthma management interventions specified, 14 differed significantly
in the frequency with which they were conducted by the two groups
of health professionals and 12 were carried out significantly more
frequently by GPs than nurses (p<0.01, chi-squared test). However, a number
of interventions considered important in the appropriate management
of asthma were conducted infrequently by both groups; only 15% of respondents in each group ‘always’ advised patients on the importance
of using a peak flow meter to monitor asthma control.
Communication of both GPs and practice nurses with community
pharmacists was infrequent and did not differ between the two groups.
GPs generally carried out the specified
asthma management interventions significantly more frequently than
nurses and this may explain the differences in opinions on asthma
management between the two groups. However, as a number of
important interventions are being conducted infrequently by both
groups, this may potentially lead to sub-optimal asthma control.