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Organisation of asthma care in primary health care in Mid-Sweden
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi. (Family Medicine and Clinical Epidemiology)
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i D län (CKFD). (Family Medicine and Clinical Epidemiology)
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi. (Family Medicine and Clinical Epidemiology)
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi. (Family Medicine and Clinical Epidemiology)
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2005 (Engelska)Ingår i: Primary Care Respiratory Journal, ISSN 1471-4418, E-ISSN 1475-1534, Vol. 14, nr 3, s. 147-153Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

AIM: To investigate the organisation of asthma care in 240 primary health care centres (PHCCs) in Mid-Sweden. METHODS: A cross-sectional study. Main outcomes were occurrence and structure of nurse-based asthma clinics according to nationally recommended criteria, and access and use of spirometers. RESULTS: 238 PHCCs (99%) responded. 16% reported a complete, and 37% an incomplete, asthma clinic. 47% of PHCCs had no asthma clinic. The incomplete asthma clinics usually lacked sufficient asthma nurse time, a scheduled nurse surgery and a responsible GP. 77% of the PHCCs had access to a spirometer and on average 19 spirometries/1000 inhabitants/year were performed. There was a large variation in the use of spirometers. CONCLUSION: Half of the PHCCs had an asthma clinic and a majority had access to a spirometer. More frequent use of spirometry and increased time provision for the asthma nurse would be likely to produce a substantial improvement in the standard of asthma care in primary health care.

Ort, förlag, år, upplaga, sidor
2005. Vol. 14, nr 3, s. 147-153
Nyckelord [en]
Asthma, Primary health care, Quality of health care, Asthma clinic, Spirometer
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
URN: urn:nbn:se:uu:diva-97620DOI: 10.1016/j.pcrj.2005.03.003PubMedID: 16701714OAI: oai:DiVA.org:uu-97620DiVA, id: diva2:172637
Tillgänglig från: 2008-10-17 Skapad: 2008-10-17 Senast uppdaterad: 2017-12-14Bibliografiskt granskad
Ingår i avhandling
1. Organisation of Asthma in Primary Care, Quality of Life and Sex-related Aspects in Asthma Outcomes
Öppna denna publikation i ny flik eller fönster >>Organisation of Asthma in Primary Care, Quality of Life and Sex-related Aspects in Asthma Outcomes
2008 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Objectives: To investigate the organisation of asthma care in primary care and evaluate outcomes for patients attending primary care centres with and without asthma clinics.

Other objectives were to study the association between quality of life and asthma control in patients in primary care and to analyse sex differences regarding asthma outcomes related to menopausal status.

Material and methods: Cross-sectional surveys and a patient record study.

Results: Of all the primary health care centres, 77% had a spirometer and 53% an asthma clinic. At centres with asthma clinics 77% of the patients reported sufficient knowledge of asthma as compared with 65% at centres without asthma clinics (p<0.001). With more time allocated for the nurse, 44% of patients achieved asthma control as compared with 27% at asthma clinics with less time (p<0.003). Patients using short-acting beta-2 agonists more than twice in the last week had clinically significant lower MiniAQLQ scores (5.17 versus 5.91). This finding also held for night awakenings during the previous week (4.42 versus 5.86), courses of oral corticosteroids (5.26 versus 5.64) and reported emergency consultations during the last six months (4.85 versus 5.71). Premenopausal women had significantly lower total MiniAQLQ scores than men in the same age group (5.44 versus 5.89, p<0.001), while no difference was found between postmenopausal women and men of similar ages. The adjusted odds for premenopausal women for asthma exacerbations was 2.0 (95%CI 1.22-3.43) as compared with men in the same age group. No differences were found when comparing postmenopausal women with men of similar ages.

Conclusions: Half the primary health care centres had an asthma clinic and the majority had access to a spirometer. Patients at primary health care centres with asthma clinics reported better knowledge of their disease, and asthma control is more often achieved if the nurse is allocated more time. Achieving asthma control is associated with better quality of life in patients in primary care. Premenopausal women had lower quality of life and less often asthma control then men of the same ages, while no corresponding difference was found between postmenopausal women and men of similar ages.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2008. s. 63
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 384
Nyckelord
Asthma, Primary Health Care, Cross-Sectional Studies, Quality of Health Care, Asthma clinic, Spirometer, Asthma management, Knowledge, Outcome Assessment, Control, Symptoms, Quality of Life, Sex, Menopause, Sex Hormones
Nationell ämneskategori
Allmänmedicin
Identifikatorer
urn:nbn:se:uu:diva-9315 (URN)978-91-554-7304-4 (ISBN)
Disputation
2008-11-07, Rudbecksalen, Rudbecklaboratoriet, Science Park, Uppsala, 09:15 (Engelska)
Opponent
Handledare
Tillgänglig från: 2008-10-17 Skapad: 2008-10-17 Senast uppdaterad: 2018-01-13Bibliografiskt granskad

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Primary Care Respiratory Journal
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi

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