PubMed Health⌕ Search

Biomedical subjects

Gaylor Hoskins

Publications and source records attributed to Gaylor Hoskins.

4 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

Do the British Guidelines for Asthma Management facilitate concordance?

BACKGROUND: Asthma is an example of a common, chronic illness in which clinicians are encouraged to promote concordance and adhere to guidelines. Some existing research suggests that these aims may be incompatible. OBJECTIVES: To describe patient goals for life and for asthma management in order to inform concordance with people with asthma. DESIGN: A cross-sectional, qualitative survey. SETTING AND PARTICIPANTS: A purposive sample of 47 adults with asthma from Dundee, UK. The subjects were identified from general practice asthma registers and had a range of ages and asthma severity but no significant comorbidity. METHODS: Tape-recorded semi-structured interviews. The topic guide was based on the literature and had been piloted in a previous study. RESULTS: The participants focussed on improving their lives, only aiming to improve their asthma as a means of improving their lives. Three aspects of asthma were reported to help or hinder improving life: the use of asthma medication, trigger avoidance and exercise. People integrated these three aspects of asthma in order to maximize life. CONCLUSIONS: The study supports the more individualized goals of the recently revised British Guidelines for Asthma Management but highlights the need to develop this further in future revisions. It also provides an explanation for patients' acceptance of less than 'perfect' asthma control and it suggests that shared goals may be achieved in practice by considering the advantages and disadvantages of medication and allergen avoidance on everyday life rather than on asthma.

Adolescent↗