32912
document
An exploratory , pragmatic , cluster randomised trial of practice nurse training in the use of asthma action plans . INTRODUCTION To investigate the feasibility of improving asthma management - in particular , the implementation of individualised asthma action plans ( AAPs ) for poorly-controlled adult asthma patients - by providing training in asthma-focused clinical and communication skills for practice nurses who deliver asthma clinics . METHODS A pragmatic , cluster randomised trial with an intervention ( an interactive seminar ) delivered at practice level ( n=13 practices ; 6=intervention , 7=control ) . The impact of the intervention was assessed against patient outcomes : routinely available asthma outcome measures ( beta2-agonist prescription rate and number of oral steroid courses ) for asthma patients identified as being poorly-controlled from practice records ; and questionnaire data - Mini Asthma Quality of Life Questionnaire ( AQLQ ) and the Asthma Control Questionnaire ( ACQ ) - from a subset of consenting patients . Data was collected at baseline and at 6-month follow-up . ANALYSISs : Routine data was analysed for 629 patients . 236 ( 37 % ) of these patients consented to provide questionnaire data at baseline , with 75 % returning questionnaires at follow-up . After adjustment for baseline and practice , there was a significant difference at followup between intervention and control practices on the Mini AQLQ only ( p=0.03 ) . Estimates for subsequent sample sizes to inform future trials of asthma training were identified . CONCLUSION Training designed to support practice nurses in implementing individualised AAPs impacted on one patient outcome only . This disappointing outcome may have been due to many different factors such as outcome measure limitations , data collection problems , and underestimating the complexity of supporting practice nurses in behaviour change .
32913
Intervention_Educational
practice nurse training
32914
Intervention_Physical
individualised asthma action plans ( AAPs )
32915
Outcome_Other
feasibility
32916
Outcome_Physical
patient outcomes : routinely available asthma outcome measures (
32917
Outcome_Other
beta2-agonist prescription rate
32918
Outcome_Physical
and
32919
Outcome_Other
number of oral steroid courses
32920
Outcome_Physical
)
32921
Outcome_Other
questionnaire data
32922
Outcome_Physical
- Mini Asthma Quality of Life Questionnaire ( AQLQ ) and the Asthma Control Questionnaire ( ACQ )
32923
Outcome_Physical
Mini AQLQ
32924
Participant_Condition
asthma
32925
Participant_Age
adult
32926
Participant_Condition
asthma
32927
Participant_Condition
asthma
32928
Participant_Sample-size
n=13
32929
Participant_Sample-size
6=intervention
32930
Participant_Sample-size
7=control
32931
Participant_Sample-size
629
32932
Participant_Sample-size
236