Although weak evidence suggests that lay-led and peer support interventions could lead to a small improvement in asthma-related quality of life for adolescents, benefits for asthma control, exacerbations and medication adherence remain unproven. Current evidence is insufficient to reveal whether routine use of lay-led or peer support programmes is beneficial for adolescents receiving asthma care.Ongoing and future research may help to identify target populations for lay-led and peer support interventions, along with attributes that constitute a successful programme.
Asthma education for school staff increases asthma knowledge and preparedness, but studies vary and all available evidence is of low quality. Studies have not yet captured whether this improvement in knowledge has led to appreciable benefits over the short term or the longer term for the safety and health of children with asthma in school. Randomised evidence does not contribute to our knowledge of content or attributes of interventions that lead to the best outcomes, or of resources required for successful implementation.Complete reporting of the content and resources of educational interventions is essential for assessment of their effectiveness and feasibility for implementation. This applies to both randomised and non-randomised studies, although the latter may be better placed to observe important clinical outcomes such as exacerbations and mortality in the longer term.
Aims: To assess the technical performance of spirometry in one general practice, and then to deliver in-house education to effect change.Methods: Retrospective audit of 45 spirometry reports assessed against possible alternative quality criteria. Three subsequent educational interventions for those clinicians performing and interpreting spirometry. Re-audit of 45 spirometry report sheets four months later against the same criteria.Results: 38% of the initial post-bronchodilator spirometries were technically flawed. Post-education, 2% of spirometries were technically flawed and respiratory referrals fell by 50%.
Conclusion:The technical quality of practice spirometry can be audited. In-house education significantly reduced spirometry errors and was associated with a 50% reduction in respiratory referrals.
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