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Biomedical subjects

Colin McCowan

Publications and source records attributed to Colin McCowan.

6 recordsLinked to original sources
PubMed2005

Results of a national asthma campaign survey of primary care in Scotland.

OBJECTIVE: To identify within primary care in Scotland how far procedures for asthma review and patient education match guideline recommendations. DESIGN AND SETTING: Telephone survey of a one in four stratified random sample of all 1058 general practices in Scotland. PARTICIPANTS: Practice nurses, general practitioners. MAIN OUTCOME MEASURES: Number of practices matching guideline recommendations for asthma review, targeting of care, use of structured asthma records, provision of management plans, education, and regular audit. RESULTS: Of 276 general practices contacted 91% (251) completed the questionnaire; 93% (228) ran an asthma review service; 74% (166) employed a specially trained asthma nurse; 39% (106) had a policy for providing action plans; 63% (155) had carried out an asthma audit in the previous 3 years; 76% (218) used a structured tool in consultations, 46% with use of computer technology, 34% used only a manual stamp. Sixty-six per cent (173) had searched for patients overusing beta2 agonists; 32% (79) had searched for patients on medication treatment step 3 and above. Single- or two-partner practices were less likely to follow guideline recommendations but neither rurality nor deprivation was related to guideline compliance. CONCLUSIONS: Three-quarters of Scottish general practices have trained asthma nurses and offer patients asthma review, but only a minority have proactive care procedures for targeting patients or a policy for providing patients with action plans. Practice systems are underused for identifying 'at-risk' patients. There is a need for proactive procedures and provision of self-management materials to patients. Access to trained asthma nurses needs to be improved.

Asthma↗
PubMed2005

An academic, pharmaceutical and practice collaboration to implement asthma guidelines.

AIMS: To investigate whether a patient review service changes the management of asthma in accordance with BTS/SIGN Guidelines. METHODS: An observational study of routine review consultations for patients with asthma registered at 862 practices throughout the United Kingdom. Practices recorded reviews on a computer template and returned the information to an academic unit for analysis. RESULTS: 41,493 patients had data returned with 14,790 (36%) patients reporting symptoms at rest or on a daily basis and 15,840 (38%) patients over-using their short-acting beta2-agonist. 4,556 (74%) of patients with symptoms who had a subsequent consultation reported a reduction in their symptoms, whilst 3,932 (63%) reported a reduction in short-acting beta2-agonist use. Night-time, daytime, and activity symptom scores, and short-acting beta2-agonist use, were significantly reduced for patients reviewed more than once. CONCLUSION: There are a large proportion of patients suffering symptoms at rest or on a daily basis. There was a significant reduction in symptom levels and use of reliever medication for patients who were reviewed. A review service implementing the BTS/SIGN guidelines for asthma management would seem to improve patient outcomes.

Journal Article↗
PubMed2004

A survey of GP attitudes to and experiences of email consultations.

Email is an accepted part of modern communication in business and education. The use of email could benefit communication between patients and healthcare professionals. Use of email within health care has been hampered by concerns about privacy, technical barriers, perceived fear of change and increased workload.Sixty-two general practitioners within Dundee in east Scotland responded to a questionnaire and indicated that they regularly used email for communication within their practices and with outside agencies, but rarely with patients. Many perceived a need to provide an email service for clinical enquiries and repeat prescription requests but felt constrained from doing so by a lack of an accepted system and workload concerns.

Attitude of Health Personnel↗
PubMed2004

Email consultations in general practice.

BACKGROUND: Email is an established method of communication in business, leisure and education but not yet health care. AIM: To evaluate an email service enabling communication between patients and their general practice regarding repeat prescriptions, appointment booking and clinical enquiries. DESIGN: Qualitative analysis of interactions and an electronic user survey. SETTING: An urban practice in Dundee, Scotland. PARTICIPANTS: 150 patients aged 24 to 85. METHODS: We set up a practice facility to allow our patients to use email to book appointments, order repeat prescriptions and consult their general practitioner (GP). RESULTS: Patient satisfaction with the service was very high. Patients specifically commended the practice for setting up a facility to allow communication outside standard working hours and for the ease of ordering repeat prescriptions. Patients were pleased to have a means of seeking their doctor's comment or opinion without bothering him or her by making and attending a formal face-to-face consultation. Email dialogue was polite, factual, but less formal than standard letters. Staff did not experience any perceptible rise in workload. CONCLUSIONS: Use of an email consultation facility worked well within an urban practice, was deemed helpful by patients, and resulted in no apparent increase in GP workload. Our results suggest that there may be an unmet need amongst patients for clinical email services, and that such services may have positive outcomes for patients and practices.

Adult↗