Asthma cycle of care attendance: Overcoming therapeutic inertia using an asthma clinic

Background: The prevalence of asthma is high in Australia. Despite national guidelines recommending the use of an Asthma Action Plan only 22.5% of people with asthma had a plan in 2004-2005. Methods: To ascertain the effect on attendance for an annual Asthma Cycle of Care resulting in an Asthma Action Plan, a retrospective audit was conducted looking at the 4 years commencing July 2005 of an asthma clinic in a group general practice in Bundaberg, Queensland, of 1 year of active recruitment (via telephone) from a database, and subsequent 3 years of opportunistic recruitment using a 'no asthma plan - no repeat script' policy in conjunction with recall. The practice population in 2005 was 2941 standardised whole patient equivalents including 243 asthmatics on preventers. The main outcome measure was the number of patients completing an annual Asthma Cycle of Care. Results: Completion of an annual Asthma Cycle of Care increased from a baseline of 30% (preclinic starting) to 38% at year 1, 64% at year 2, fell back to 45% at year 3, and rose to 59% at end year 4, with nearly all cycles of care being completed via the asthma clinic. Discussion: Opportunistic recruitment addressing therapeutic inertia combined with recall may be more effective than active recruitment via telephone