Abstract
To evaluate a project to implement guidelines on the management of patients with asthma or chronic obstructive pulmonany disease (COPD) in terms of the health outcomes of these patients. A before-and-after study of 1 year with a non-randomized but comparable reference group. General practices in the Netherlands. Two-hundred and eighty patients from 14 practices in the intervention group and 90 patients from five practices in the reference group (receiving usual care). The project included a comprehensive implementation programme, involving identification of barriers, documentation of the care provided, specific education, feedback on compliance with the guidelines, and peer review. This project has been found to bring the process of care more in agreement with the guidelines. Mean peak expiratory flow rate (PEFR) as a percentage of the predicted value, number of days with a diurnal variation in PEFR > or = 15%, number of days with respiratory symptoms (all recorded by patients for a period of 14 days), and perceived health status (Nottingham Health Profile). After 1 year, the intervention group showed statistically significant improvements with regard to the mean PEFR, the diurnal variation in PEFR, respiratory symptoms and the...Continue Reading
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