Proactive asthma care in childhood: general practice based randomised controlled trial.

Abstract:

OBJECTIVES:To assess the feasibility and effectiveness of a general practice based, proactive system of asthma care in children. DESIGN:Randomised controlled trial with cluster sampling by general practice. SETTING:General practices in the northern region of the Australian Capital Territory. PARTICIPANTS:174 children with moderate to severe asthma who attended 24 general practitioners. INTERVENTION:System of structured asthma care (the 3+ visit plan), with participating families reminded to attend the general practitioner. MAIN OUTCOME MEASURES:Process measures: rates for asthma consultations with general practitioner, written asthma plans, completion of the 3+ visit plan; clinical measures: rates for emergency department visits for asthma, days absent from school, symptom-free days, symptoms over the past year, activity limitation over the past year, and asthma drug use over the past year; spirometric lung function measures before and after cold air challenge. RESULTS:Intervention group children had significantly more asthma related consultations (odds ratio for three or more asthma related consultations 3.8 (95% confidence interval 1.9 to 7.6; P = 0.0001), written asthma plans (2.2 (1.2 to 4.1); P = 0.01), and completed 3+ visit plans (24.2 (5.7 to 103.2); P = 0.0001) than control children and a mean reduction in measurements of forced expiratory volume in one second after cold air challenge of 2.6% (1.7 to 3.5); P = 0.0001) less than control children. The number needed to treat (benefit) for one additional written asthma action plan was 5 (3 to 41) children. Intervention group children had lower emergency department attendance rates for asthma (odds ratio 0.4 (0.2 to 1.04); P = 0.06) and less speech limiting wheeze (0.2 (0.1 to 0.4); P = 0.0001) than control children and were more likely to use a spacer (2.8 (1.6 to 4.7); P = 0.0001). No differences occurred in number of days absent from school or symptom-free day scores. CONCLUSIONS:Proactive care with active recall for children with moderate to severe asthma is feasible in general practice and seems to be beneficial.

journal_name

BMJ

authors

Glasgow NJ,Ponsonby AL,Yates R,Beilby J,Dugdale P

doi

10.1136/bmj.327.7416.659

keywords:

subject

Has Abstract

pub_date

2003-09-20 00:00:00

pages

659

issue

7416

eissn

0959-8138

issn

1756-1833

pii

327/7416/659

journal_volume

327

pub_type

临床试验,杂志文章,随机对照试验
  • Cancer patients' information needs and information seeking behaviour: in depth interview study.

    abstract:OBJECTIVES:To explore why cancer patients do not want or seek information about their condition beyond that volunteered by their physicians at times during their illness. DESIGN:Qualitative study based on in-depth interviews. SETTING:Outpatient oncology clinics at a London cancer centre. PARTICIPANTS:17 patients wit...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.320.7239.909

    authors: Leydon GM,Boulton M,Moynihan C,Jones A,Mossman J,Boudioni M,McPherson K

    更新日期:2000-04-01 00:00:00

  • Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis.

    abstract:OBJECTIVE:To evaluate the relative efficacy of the World Health Organization 2005 campaign (WHO-5) and other interventions to promote hand hygiene among healthcare workers in hospital settings and to summarize associated information on use of resources. DESIGN:Systematic review and network meta-analysis. DATA SOURCES...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.h3728

    authors: Luangasanatip N,Hongsuwan M,Limmathurotsakul D,Lubell Y,Lee AS,Harbarth S,Day NP,Graves N,Cooper BS

    更新日期:2015-07-28 00:00:00

  • Risk of cervical and other cancers after treatment of cervical intraepithelial neoplasia: retrospective cohort study.

    abstract:OBJECTIVE:To study the long term risk of cervical and other cancers after treatment for cervical intraepithelial neoplasia. DESIGN:Retrospective cohort study. SETTING:University Hospital, Helsinki, Finland. PARTICIPANTS:7564 women treated for cervical intraepithelial neoplasia during 1974 and 2001 and followed up th...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.38663.459039.7C

    authors: Kalliala I,Anttila A,Pukkala E,Nieminen P

    更新日期:2005-11-19 00:00:00

  • Relation between troponin T concentration and mortality in patients presenting with an acute stroke: observational study.

    abstract:OBJECTIVE:To assess whether a raised serum troponin T concentration would be an independent predictor of death in patients with an acute ischaemic stroke. DESIGN:Observational study. SETTING:Auckland Hospital, Auckland, New Zealand. SUBJECTS:All 181 patients with an acute ischaemic stroke admitted over nine months i...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.320.7248.1502

    authors: James P,Ellis CJ,Whitlock RM,McNeil AR,Henley J,Anderson NE

    更新日期:2000-06-03 00:00:00

  • Assessing the risk of venous thromboembolic events in women taking progestin-only contraception: a meta-analysis.

    abstract:OBJECTIVES:To evaluate the risk of venous thromboembolic events associated with the use of progestin-only contraception and whether that risk differs with the mode of drug delivery (oral, intrauterine, or depot injection). DESIGN:Systematic review and meta-analysis of randomised controlled trials and observational stu...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.e4944

    authors: Mantha S,Karp R,Raghavan V,Terrin N,Bauer KA,Zwicker JI

    更新日期:2012-08-07 00:00:00

  • Cost effectiveness analysis of a randomised trial of acupuncture for chronic headache in primary care.

    abstract:OBJECTIVE:To evaluate the cost effectiveness of acupuncture in the management of chronic headache. DESIGN:Cost effectiveness analysis of a randomised controlled trial. SETTING:General practices in England and Wales. PARTICIPANTS:401 patients with chronic headache, predominantly migraine. Interventions Patients were ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.38033.896505.EB

    authors: Wonderling D,Vickers AJ,Grieve R,McCarney R

    更新日期:2004-03-27 00:00:00

  • Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis.

    abstract:OBJECTIVE:To develop an evidence base for recommendations on the use of atypical antipsychotics for patients with schizophrenia. DESIGN:Systematic overview and meta-regression analyses of randomised controlled trials, as a basis for formal development of guidelines. SUBJECTS:12 649 patients in 52 randomised trials co...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.321.7273.1371

    authors: Geddes J,Freemantle N,Harrison P,Bebbington P

    更新日期:2000-12-02 00:00:00

  • Evaluation of modernisation of adult critical care services in England: time series and cost effectiveness analysis.

    abstract:OBJECTIVE:To evaluate the impact and cost effectiveness of a programme to transform adult critical care throughout England initiated in late 2000. DESIGN:Evaluation of trends in inputs, processes, and outcomes during 1998-2000 compared with last quarter of 2000-6. SETTING:96 critical care units in England. PARTICIPA...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.b4353

    authors: Hutchings A,Durand MA,Grieve R,Harrison D,Rowan K,Green J,Cairns J,Black N

    更新日期:2009-11-11 00:00:00

  • Positive and negative factors in defensive medicine: a questionnaire study of general practitioners.

    abstract:OBJECTIVES:(a) To investigate defensive medical practices among general practitioners; (b) to compare any such practices with general practitioners' understanding of certain aspects of the terms of service and medical negligence and practitioners' concerns about the risk of being sued or having a complaint lodged. DES...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6971.27

    authors: Summerton N

    更新日期:1995-01-07 00:00:00

  • Latex agglutination test for diagnosing pneumococcal pneumonia in children in developing countries.

    abstract:OBJECTIVE:To prepare and assess the sensitivity and specificity of a latex agglutination test specific for the serotype of antigen in diagnosing pneumococcal pneumonia in Gambian children. DESIGN:Comparison of agglutination test specific for serotype with culture of blood and lung aspirates, countercurrent immunoelect...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章

    doi:10.1136/bmj.298.6680.1061

    authors: O'Neill KP,Lloyd-Evans N,Campbell H,Forgie IM,Sabally S,Greenwood BM

    更新日期:1989-04-22 00:00:00

  • Inverse association between cancer and Alzheimer's disease: results from the Framingham Heart Study.

    abstract:OBJECTIVES:To relate cancer since entry into the Framingham Heart Study with the risk of incident Alzheimer's disease and to estimate the risk of incident cancer among participants with and without Alzheimer's disease. DESIGN:Community based prospective cohort study; nested age and sex matched case-control study. SET...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e1442

    authors: Driver JA,Beiser A,Au R,Kreger BE,Splansky GL,Kurth T,Kiel DP,Lu KP,Seshadri S,Wolf PA

    更新日期:2012-03-12 00:00:00

  • Weight growth in infants born to mothers who smoked during pregnancy.

    abstract:OBJECTIVE:To determine whether maternal smoking during pregnancy causes impairment in growth after birth. DESIGN:Longitudinal study. SETTING:Six medical university centres of six towns of north, central, and south Italy. SUBJECTS:12,987 babies (10,238 born from non-smoking mothers, 2276 from mothers smoking one to n...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6982.768

    authors: Conter V,Cortinovis I,Rogari P,Riva L

    更新日期:1995-03-25 00:00:00

  • Selective chromosome analysis in couples with two or more miscarriages: case-control study.

    abstract:OBJECTIVE:To identify additional factors, such as maternal age or factors related to previous reproductive outcome or family history, and the corresponding probability of carrying a chromosome abnormality in couples with two or more miscarriages. DESIGN:Nested case-control study. SETTING:Six centres for clinical gene...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.38498.669595.8F

    authors: Franssen MT,Korevaar JC,Leschot NJ,Bossuyt PM,Knegt AC,Gerssen-Schoorl KB,Wouters CH,Hansson KB,Hochstenbach R,Madan K,van der Veen F,Goddijn M

    更新日期:2005-07-16 00:00:00

  • Selection of patients for intra-arterial treatment for acute ischaemic stroke: development and validation of a clinical decision tool in two randomised trials.

    abstract::Objective To improve the selection of patients with acute ischaemic stroke for intra-arterial treatment using a clinical decision tool to predict individual treatment benefit.Design Multivariable regression modelling with data from two randomised controlled clinical trials.Setting 16 hospitals in the Netherlands (deri...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.j1710

    authors: Venema E,Mulder MJHL,Roozenbeek B,Broderick JP,Yeatts SD,Khatri P,Berkhemer OA,Emmer BJ,Roos YBWEM,Majoie CBLM,van Oostenbrugge RJ,van Zwam WH,van der Lugt A,Steyerberg EW,Dippel DWJ,Lingsma HF

    更新日期:2017-05-03 00:00:00

  • Relation of caffeine intake and blood caffeine concentrations during pregnancy to fetal growth: prospective population based study.

    abstract:OBJECTIVES:To examine the association of plasma caffeine concentrations during pregnancy with fetal growth and to compare this with relations with reported caffeine intake. DESIGN:Prospective population based study. SETTING:District general hospital, inner London. SUBJECTS:Women booking for delivery between 1982 and...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.313.7069.1358

    authors: Cook DG,Peacock JL,Feyerabend C,Carey IM,Jarvis MJ,Anderson HR,Bland JM

    更新日期:1996-11-30 00:00:00

  • Is an information booklet for patients leaving hospital helpful and useful?

    abstract:OBJECTIVE:To determine whether a booklet given to patients being discharged from hospital giving details of their admission and treatment increased their knowledge and recall when reviewed in outpatient clinics. DESIGN:Patients alternately allocated to receive a booklet or to serve as controls. Assessment by a questio...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章

    doi:10.1136/bmj.298.6677.870

    authors: Sandler DA,Mitchell JR,Fellows A,Garner ST

    更新日期:1989-04-01 00:00:00

  • Association of soy and fermented soy product intake with total and cause specific mortality: prospective cohort study.

    abstract:OBJECTIVE:To investigate the association between several types of soy products and all cause and cause specific mortality. DESIGN:Population based cohort study. SETTING:Japan Public Health Centre-based Prospective Study, which includes 11 public health centre areas in Japan. PARTICIPANTS:92 915 participants (42 750 ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.m34

    authors: Katagiri R,Sawada N,Goto A,Yamaji T,Iwasaki M,Noda M,Iso H,Tsugane S,Japan Public Health Center-based Prospective Study Group.

    更新日期:2020-01-29 00:00:00

  • Role of peak bone mass and bone loss in postmenopausal osteoporosis: 12 year study.

    abstract:OBJECTIVE:To examine the role of peak bone mass and subsequent postmenopausal bone loss in the development of osteoporosis and the reliability of identifying women at risk from one bone mass measurement and one biochemical assessment of the future bone loss. DESIGN:Population based study. SETTING:Outpatient clinic fo...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.303.6808.961

    authors: Hansen MA,Overgaard K,Riis BJ,Christiansen C

    更新日期:1991-10-19 00:00:00

  • Compression ultrasonography for diagnostic management of patients with clinically suspected deep vein thrombosis: prospective cohort study.

    abstract:OBJECTIVE:To evaluate the safety of withholding anticoagulant treatment from patients with clinically suspected deep vein thrombosis but normal findings on compression ultrasonography. DESIGN:Compression ultrasonography was done with a simplified diagnostic procedure limited to the common femoral vein in the groin and...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.316.7124.17

    authors: Cogo A,Lensing AW,Koopman MM,Piovella F,Siragusa S,Wells PS,Villalta S,Büller HR,Turpie AG,Prandoni P

    更新日期:1998-01-03 00:00:00

  • Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit.

    abstract:OBJECTIVE:To identify the number of patients who were misdiagnosed as being in the vegetative state and their characteristics. DESIGN:Retrospective study of the clinical records of the medical, occupational therapy, and clinical psychology departments. SETTING:20 bed unit specialising in the rehabilitation of patient...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.313.7048.13

    authors: Andrews K,Murphy L,Munday R,Littlewood C

    更新日期:1996-07-06 00:00:00

  • Prenatal and postnatal prevalence of Turner's syndrome: a registry study.

    abstract:OBJECTIVE:To study prevalence of Turner's syndrome in Denmark and to assess validity of prenatal diagnosis. DESIGN:Study of data on prenatal and postnatal Turner's syndrome in Danish Cytogenetic Central Register. SUBJECTS:All registered Turner's syndrome karyotypes (100 prenatal cases and 215 postnatal cases) during ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.312.7022.16

    authors: Gravholt CH,Juul S,Naeraa RW,Hansen J

    更新日期:1996-01-06 00:00:00

  • Needs for care from a demand led community psychiatric service: a study of patients with major mental illness.

    abstract:UNLABELLED:OBJECTIVE--To measure needs for care of patients aged 18-65 years with major mental illness. DESIGN:Identification of everyone in one area seen by a health professional within the previous five years because of a psychotic disorder. Interview of a one in three sample of patients and their main carers with t...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.312.7046.1582

    authors: Murray V,Walker HW,Mitchell C,Pelosi AJ

    更新日期:1996-06-22 00:00:00

  • Effectiveness of early switch from intravenous to oral antibiotics in severe community acquired pneumonia: multicentre randomised trial.

    abstract:OBJECTIVES:To compare the effectiveness of an early switch to oral antibiotics with the standard 7 day course of intravenous antibiotics in severe community acquired pneumonia. DESIGN:Multicentre randomised controlled trial. SETTING:Five teaching hospitals and 2 university medical centres in the Netherlands. PARTICI...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.38993.560984.BE

    authors: Oosterheert JJ,Bonten MJ,Schneider MM,Buskens E,Lammers JW,Hustinx WM,Kramer MH,Prins JM,Slee PH,Kaasjager K,Hoepelman AI

    更新日期:2006-12-09 00:00:00

  • How good is general practice developmental screening?

    abstract::All developmental screening in Somerset is performed by general practitioners and health visitors. A retrospective review of a cohort of 1504 7 year old children living in semirural Somerset found that the development assessment by a health visitor at age 3 1/2 years had a sensitivity of 45% for identifying the 103 ch...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.300.6733.1177

    authors: Dearlove J,Kearney D

    更新日期:1990-05-05 00:00:00

  • Immune response to a new hepatitis B vaccine in healthcare workers who had not responded to standard vaccine: randomised double blind dose-response study.

    abstract:OBJECTIVE:To evaluate the immunogenicity and reactogenicity of a new triple S recombinant hepatitis B vaccine in a cohort of healthy people in whom currently licensed hepatitis B vaccines had persistently not induced an immune response. DESIGN:Single centre, randomised, double blind, dose-response study. SETTING:Rese...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.314.7077.329

    authors: Zuckerman JN,Sabin C,Craig FM,Williams A,Zuckerman AJ

    更新日期:1997-02-01 00:00:00

  • Residence near high voltage facilities and risk of cancer in children.

    abstract:OBJECTIVE:To investigate whether residence before and after birth near 50 Hz high voltage installations increases a child's risk of cancer and whether risk correlates with the strength of the magnetic field. DESIGN:A population based case-control study. SETTING:Denmark. SUBJECTS:1707 children under the age of 15 wit...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.307.6909.891

    authors: Olsen JH,Nielsen A,Schulgen G

    更新日期:1993-10-09 00:00:00

  • Cost effectiveness analysis of strategies to combat HIV/AIDS in developing countries.

    abstract:OBJECTIVE:To assess the costs and health effects of a range of interventions for preventing the spread of HIV and for treating people with HIV/AIDS in the context of the millennium development goal for combating HIV/AIDS. DESIGN:Cost effectiveness analysis based on an epidemiological model. SETTING:Analyses undertake...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.38643.368692.68

    authors: Hogan DR,Baltussen R,Hayashi C,Lauer JA,Salomon JA

    更新日期:2005-12-17 00:00:00

  • International variation in radiation dose for computed tomography examinations: prospective cohort study.

    abstract:OBJECTIVE:To determine patient, institution, and machine characteristics that contribute to variation in radiation doses used for computed tomography (CT). DESIGN:Prospective cohort study. SETTING:Data were assembled and analyzed from the University of California San Francisco CT International Dose Registry. PARTICI...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.k4931

    authors: Smith-Bindman R,Wang Y,Chu P,Chung R,Einstein AJ,Balcombe J,Cocker M,Das M,Delman BN,Flynn M,Gould R,Lee RK,Yellen-Nelson T,Schindera S,Seibert A,Starkey J,Suntharalingam S,Wetter A,Wildberger JE,Miglioretti DL

    更新日期:2019-01-02 00:00:00

  • Breast feeding and risk of breast cancer in young women. United Kingdom National Case-Control Study Group.

    abstract:OBJECTIVE:To investigate whether breast feeding is related to subsequent risk of breast cancer. DESIGN:Population based case-control study designed primarily to investigate the relation between oral contraceptives and risk of breast cancer; data obtained from questionnaires administered by interviewers, general practi...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.307.6895.17

    authors:

    更新日期:1993-07-03 00:00:00

  • Detection of mild to moderate influenza A/H7N9 infection by China's national sentinel surveillance system for influenza-like illness: case series.

    abstract:OBJECTIVE:To characterise the complete case series of influenza A/H7N9 infections as of 27 May 2013, detected by China's national sentinel surveillance system for influenza-like illness. DESIGN:Case series. SETTING:Outpatient clinics and emergency departments of 554 sentinel hospitals across 31 provinces in mainland ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.f3693

    authors: Ip DK,Liao Q,Wu P,Gao Z,Cao B,Feng L,Xu X,Jiang H,Li M,Bao J,Zheng J,Zhang Q,Chang Z,Li Y,Yu J,Liu F,Ni MY,Wu JT,Cowling BJ,Yang W,Leung GM,Yu H

    更新日期:2013-06-24 00:00:00