Trial reportBMJ (Clinical research ed.)2004
Specialist nurse intervention to reduce unscheduled asthma care in a deprived multiethnic area: the east London randomised controlled trial for high risk asthma (ELECTRA).
Trial report in BMJ (Clinical research ed.), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 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
31 citing papers in PubMed, 10 syntheses or guidelines pooled it, 123 citations in OpenAlex.
- Caseworker-assigned discharge plans to prevent hospital readmission for acute exacerbations in children with chronic respiratory illness.The Cochrane database of systematic reviews · 2018Pooled it
- Interventions to enhance the adoption of asthma self-management behaviour in the South Asian and African American population: a systematic review.NPJ primary care respiratory medicine · 2018Pooled it
- Personalised asthma action plans for adults with asthma.The Cochrane database of systematic reviews · 2017Pooled it
- Walk-in clinics versus physician offices and emergency rooms for urgent care and chronic disease management.The Cochrane database of systematic reviews · 2017Pooled it
- Nurse versus physician-led care for the management of asthma.The Cochrane database of systematic reviews · 2013Pooled it
- Primary care based clinics for asthma.The Cochrane database of systematic reviews · 2012Pooled it
- Home-based educational interventions for children with asthma.The Cochrane database of systematic reviews · 2011Pooled it
- Asthma in adults (acute).BMJ clinical evidence · 2011Pooled it
- Asthma in adults.BMJ clinical evidence · 2010Pooled it
- Educational outreach visits: effects on professional practice and health care outcomes.The Cochrane database of systematic reviews · 2007Pooled it
- Education-only versus a multifaceted intervention for improving assessment of rehabilitation needs after stroke; a cluster randomised trial.Implementation science : IS · 2016Trial
- Effect of an Education Programme for South Asians with Asthma and Their Clinicians: A Cluster Randomised Controlled Trial (OEDIPUS).PloS one · 2016Trial
- Randomised controlled trial of a lay-led self-management programme for Bangladeshi patients with chronic disease.The British journal of general practice : the journal of the Royal College of General Practitioners · 2005Trial
- Article
- Asthma/COPD clinics increases adherence to management guidelines and associates with less morbidity and lower all-cause mortality - a prospective cohort study.NPJ primary care respiratory medicine · 2026Article
- Are acute asthma presentations to the emergency department an opportunity for optimising long-term management? A qualitative study on beliefs and behaviours of healthcare professionals.Emergency medicine journal : EMJ · 2025Article
- Optimizing care for children with difficult-to-treat and severe asthma through specialist paediatric asthma centres: expert practical experience and advice.BMC pediatrics · 2024Article
- Clinical inertia in asthma.NPJ primary care respiratory medicine · 2023Review
- Advanced Clinical Practitioners in Primary Care in the UK: A Qualitative Study of Workforce Transformation.International journal of environmental research and public health · 2020Article
- Article
Corrections and comments
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether asthma specialist nurses, using a liaison model of care, reduce unscheduled care in a deprived multiethnic area.
designCluster randomised controlled trial.
setting44 general practices in two boroughs in east London.
participants324 people aged 4-60 years admitted to or attending hospital or the general practitioner out of hours service with acute asthma; 164 (50%) were South Asian patients, 108 (34%) were white patients, and 52 (16%) were from other, largely African and Afro-Caribbean, ethnicities.
interventionPatient review in a nurse led clinic and liaison with general practitioners and practice nurses comprising educational outreach, promotion of guidelines for high risk asthma, and ongoing clinical support. Control practices received a visit promoting standard asthma guidelines; control patients were checked for inhaler technique.
main outcome measuresPercentage of participants receiving unscheduled care for acute asthma over one year and time to first unscheduled attendance.
resultsPrimary outcome data were available for 319 of 324 (98%) participants. Intervention delayed time to first attendance with acute asthma (hazard ratio 0.73, 95% confidence interval 0.54 to 1.00; median 194 days for intervention and 126 days for control) and reduced the percentage of participants attending with acute asthma (58% (101/174) v 68% (99/145); odds ratio 0.62, 0.38 to 1.01). In analyses of prespecified subgroups the difference in effect on ethnic groups was not significant, but results were consistent with greater benefit for white patients than for South Asian patients or those from other ethnic groups.
conclusionAsthma specialist nurses using a liaison model of care reduced unscheduled care for asthma in a deprived multiethnic health district. Ethnic groups may not benefit equally from specialist nurse intervention.
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Registered trials
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.