An interactive workshop plus locally adapted guidelines can improve General Practitioners asthma management and knowledge: A cluster randomised trial in the Australian setting

Siaw-Teng Liaw¹ , Nabil D Sulaiman² , Christopher A Barton³ , Patty Chondros² , Claire A Harris⁴ , Susan Sawyer⁵ and Shyamali C Dharmage⁶

¹Department of Rural Health, The University of Melbourne, Australia

²Department of General Practice, The University of Melbourne and Department of Family and Community Medicine and Behavioural Sciences, University of Sharjah, United Arab Emirates

³Discipline of General Practice, University of Adelaide, Australia

⁴Centre for Clinical Effectiveness, Monash Institute of Health Services Research, Australia

⁵Centre for Adolescent Health and Department of Respiratory Medicine, Royal Children's Hospital, Melbourne, Australia

⁶Centre for MEGA Epidemiology, School of Population Health, The University of Melbourne, Australia

author email corresponding author email

BMC Family Practice 2008, 9:22doi:10.1186/1471-2296-9-22


Published:	20 April 2008

Abstract

Background

A cluster randomised trial was conducted to determine the effectiveness of locally adapted practice guidelines and education about paediatric asthma management, delivered to general practitioners (GPs) in small group interactive workshops.

Methods

Twenty-nine practices were randomly allocated to one of three study arms. Australian asthma management guidelines were adapted to accommodate characteristics of the local area. GPs in the intervention arm (Group 1, n = 18 GPs) participated in a small group based education program and were provided with the adapted guidelines. One control arm (Group 2, n = 18 GPs) received only the adapted guidelines, while the other control arm (Group 3, n = 15 GPs) received an unrelated education intervention. GPs' knowledge, attitudes and management of paediatric asthma was assessed.

Results

Post intervention, intervention arm GPs were no more likely to provide a written asthma action plan, but were better able to assess the severity of asthma attack (Group 1vs Group 2 p = 0.05 and Group 1 vs Group 3 p = 0.01), better able to identify patients at high risk of severe attack (Group 1vs Group 3 p = 0.06), and tended to score higher on the asthma knowledge questionnaire (Group 1 vs Group 2 p = 0.06 and Group 1 vs Group 3 p = 0.2). Most intervention arm GPs felt more confident than control GPs to manage acute asthma attack and ongoing management of infrequent episodic asthma.

Conclusion

Using interactive small group workshops to disseminate locally adapted guidelines was associated with improvement in GP's knowledge and confidence to manage asthma, but did not change GP's self-reported provision of written action plans.