Trial reportBMJ (Clinical research ed.)1999
Clustered randomised trial of an intervention to improve the management of asthma: Greenwich asthma study.
Trial report in BMJ (Clinical research ed.), 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 10 syntheses or guidelines pooled it, 94 citations in OpenAlex.
- Use and effects of implementation strategies for practice guidelines in nursing: a systematic review.Implementation science : IS · 2021Pooled it
- Continuing education meetings and workshops: effects on professional practice and healthcare outcomes.The Cochrane database of systematic reviews · 2021Pooled it
- Chronic disease management programmes for adults with asthma.The Cochrane database of systematic reviews · 2015Pooled it
- Interventions to modify health care provider adherence to asthma guidelines: a systematic review.Pediatrics · 2013Pooled it
- Primary care based clinics for asthma.The Cochrane database of systematic reviews · 2012Pooled it
- Continuing education meetings and workshops: effects on professional practice and health care outcomes.The Cochrane database of systematic reviews · 2009Pooled it
- Educational outreach visits: effects on professional practice and health care outcomes.The Cochrane database of systematic reviews · 2007Pooled it
- Options for self-management education for adults with asthma.The Cochrane database of systematic reviews · 2003Pooled it
- Limited (information only) patient education programs for adults with asthma.The Cochrane database of systematic reviews · 2002Pooled it
- Self-management education and regular practitioner review for adults with asthma.The Cochrane database of systematic reviews · 2000Pooled it
- Practice-level effects of interventions to improve asthma care in primary care settings: the Pediatric Asthma Care Patient Outcomes Research Team.Health services research · 2005Trial
- Specialist nurse intervention to reduce unscheduled asthma care in a deprived multiethnic area: the east London randomised controlled trial for high risk asthma (ELECTRA).BMJ (Clinical research ed.) · 2004Trial
- Implementation of RCGP guidelines for acute low back pain: a cluster randomised controlled trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2004Trial
- A randomised controlled trial of clinics in secondary schools for adolescents with asthma.The British journal of general practice : the journal of the Royal College of General Practitioners · 2002Trial
- ERS/EAACI statement on adherence to international adult asthma guidelines.European respiratory review : an official journal of the European Respiratory Society · 2021Article
- General practitioners' intentions and prescribing for asthma: using the theory of planned behavior to explain guideline implementation.International journal of preventive medicine · 2012Article
- Frequent paracetamol use and asthma in adults.Thorax · 2000Article
- Asthma and poverty.Thorax · 2000Article
- Greenwich asthma study. Study's conclusions are premature.BMJ (Clinical research ed.) · 2000Article
- Greenwich asthma study.BMJ (Clinical research ed.) · 1999Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the effectiveness of an asthma resource centre in improving treatment and quality of life for asthmatic patients.
designCommunity based randomised controlled trial.
setting41 general practices in Greenwich with a practice nurse. SUBJECTS: All registered patients aged 15-50 years.
interventionNurse specialists in asthma who educated and supported practice nurses, who in turn educated patients in the management of asthma according to the British Thoracic Society's guidelines.
main outcome measuresQuality of life of asthmatic patients, attendance at accident and emergency departments, admissions to local hospitals, and steroid prescribing by general practitioners.
resultsOf 24 400 patients randomly selected and surveyed in 1993, 12 238 replied; 1621 were asthmatic of whom 1291 were sent a repeat questionnaire in 1996 and 780 replied. Of 24 400 patients newly surveyed in 1996, 10 783 (1616 asthmatic) replied. No evidence was found for an improvement in asthma related quality of life among newly surveyed patients in intervention practices compared with control practices. Neither was there evidence of an improvement in other measures of the quality of asthma care. Weak evidence was found for an improvement in quality of life in intervention practices among asthmatics registered with study practices in 1993 and followed up in 1996. Neither attendances at accident and emergency departments nor admissions for asthma showed any tendency to diverge in intervention and control practices over the study period. Steroid prescribing rates rose steadily during the study period. The average annual increase in steroid prescribing was 3% per year higher in intervention than control practices (95% confidence interval -1% to 6%, P=0.10).
conclusionsThis model of service delivery is not effective in improving the outcome of asthma in the community. Further development is required if cost effective management of asthma is to be introduced.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.