The effect of integrated care on asthma control

Background: Integrated care of respiratory patients has often been advocated, however, the effect on patient outcome is not clear. Objective: To describe the effect of an integrated care system on asthma control. Method: We developed an integrated care system for communication between pulmonologists and General Practitioners (GP). In this system patients with respiratory problems complete questionnaires (history, control and health status) and visit the laboratory for spirometry. These data are collected and uploaded to a central server. Based on these data without seeing the patient and supported by a decision support system the pulmonologists (n=9) give advice about diagnosis and treatment to the GP (n=250), who treats the patient. Results: From a total of 7877 patients referred to our integrated care system 3721 patients were diagnosed with asthma. In 889 of these patients ACQ data were available at baseline and follow up. The median ACQ scores at baseline (1.0) proved to be significantly different from the median ACQ scores of the follow up visit (0.7) (Z= -8.81,