Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Feasibility study of a communication and education asthma intervention for general practitioners in Australia

Smita Shah A B J , Brett G. Toelle B C , Susan M. Sawyer D E F , Jessica K. Roydhouse A B G , Peter Edwards H I , Tim Usherwood B and Christine R. Jenkins B C
+ Author Affiliations
- Author Affiliations

A Primary Health Care Education and Research Unit, Primary and Community Health Network, Sydney West Area Health Service, Sydney, NSW 2145, Australia.

B Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.

C Woolcock Institute of Medical Research, Glebe, NSW 2051, Australia.

D Centre for Adolescent Health, The Royal Children’s Hospital, Melbourne, Vic. 3052, Australia.

E Department of Paediatrics, The University of Melbourne, Vic. 3052, Australia.

F Murdoch Childrens Research Institute, Melbourne, Vic. 3052, Australia.

G Faculty of Nursing and Midwifery, University of Sydney, Sydney, NSW 2006, Australia.

H General Practitioner, Merrylands, NSW 2160, Australia.

I The University of New South Wales, Sydney, NSW 2052, Australia.

J Corresponding author. Email: smita_shah@wsahs.nsw.gov.au

Australian Journal of Primary Health 16(1) 75-80 https://doi.org/10.1071/PY09056
Published: 17 March 2010

Abstract

The Physician Asthma Care Education (PACE) program significantly improved asthma prescribing and communication behaviours of primary care paediatricians in the USA. We tested the feasibility and acceptability of a modified PACE program with Australian general practitioners (GP) and measured its impact on self-reported consulting behaviours in a pilot study. Recruitment took place through a local GP division. Twenty-five GP completed two PACE Australia workshops, which incorporated paediatric asthma management consistent with Australian asthma guidelines and focussed on effective communication strategies. Program feasibility, usefulness and perceived benefit were measured by questionnaires before the workshop and 1 month later, and an evaluation questionnaire after each workshop. GP were universally enthusiastic and supportive of the workshops. The most useful elements they reported were communication skills, case studies, device demonstrations and the toolkit provided. GP self reports of the perceived helpfulness of the key communication strategies and their confidence in their application and reported frequency of use increased significantly after the workshops. The PACE program shows promise in improving the way in which Australian GP manage asthma consultations, particularly with regard to doctor–patient communication. The impact of the modified PACE Australia program on the processes and outcomes of GP care of children with asthma is now being measured in a randomised controlled trial.

Additional keywords: clinician–patient communication, paediatric asthma management, primary health care.


Acknowledgements

We thank the general practitioners who participated in this study, and the Australian Government for their financial support of this feasibility study under the Asthma Management Program. We are grateful for the helpful advice from Professors Noreen Clark, Michael Cabana, Jo Douglass, Peter Gibson and Guy Marks.


References


Australian Centre for Asthma Monitoring (2003) ‘Asthma in Australia 2003. AIHW Asthma Series No. 1.’ (Australian Institute of Health and Welfare: Canberra)

Australian Centre for Asthma Monitoring (2008) ‘Asthma in Australia 2008. AIHW Asthma Series No. 3.’ (Australian Institute of Health and Welfare: Canberra)

Bandura A (1986) ‘Social foundations of thought and action.’ (Prentice-Hall: Englewood Cliffs, NJ)

Bauman AE, Fardy HJ, Harris PG (2003) Getting it right: why bother with patient-centred care? The Medical Journal of Australia 179, 253–256.
PubMed | open url image1

Britt H , Miller GC , Knox S , et al (2005) ‘General practice activity in Australia 2004–05.’ (Australian Institute of Health and Welfare: Canberra)

Cabana MD, Ebel BE, Cooper-Patrick L, Powe NR, Rubin HR, Rand CS (2000) Barriers pediatricians face when using asthma practice guidelines. Archives of Pediatrics & Adolescent Medicine 154, 685–693.
PubMed |  CAS | open url image1

Cabana MD, Slish KK, Evans D, Mellins RB, Brown RW, Lin X, Kaciroti N, Clark NM (2006) Impact of Physician Asthma Care Education on patient outcomes. Pediatrics 117, 2149–2157.
Crossref | GoogleScholarGoogle Scholar | PubMed | open url image1

Clark N, Gong M (2000) Management of chronic disease by practitioners and patients: are we teaching the wrong things? BMJ (Clinical Research Ed.) 320, 572–575.
Crossref | GoogleScholarGoogle Scholar | PubMed | CAS | open url image1

Clark NM, Valerio MA (2003) The role of behavioural theories in educational interventions for paediatric asthma. Paediatric Respiratory Reviews 4, 325–333.
Crossref | GoogleScholarGoogle Scholar | PubMed | open url image1

Clark NM, Gong M, Schork MA, Evans D, Roloff D, Hurwitz M, Maiman L, Mellins RB (1998) Impact of education for physicians on patient outcomes. Pediatrics 101, 831–836.
Crossref | GoogleScholarGoogle Scholar | PubMed | CAS | open url image1

Clark NM, Gong M, Schork MA , et al . (2000) Long-term effects of asthma education for physicians on patient satisfaction and use of health services. The European Respiratory Journal 16, 15–21.
Crossref | GoogleScholarGoogle Scholar | PubMed | CAS | open url image1

Gibson PG, Powell H, Coughlan J, Wilson AJ, Abramson M , et al . (20023) Self-management education and regular practitioner review for adults with asthma. Cochrane Database of Systematic Reviews (Online : Update Software) 2002(3), CD001117.
Crossref | GoogleScholarGoogle Scholar | open url image1

Goeman DP, Hogan CD, Aroni RA, Abrramson MJ, Sawyer SM, Stewart K, Sanci LA, Douglass JA (2005) Barriers to delivering asthma care: a qualitative study of general practitioners. MJA 183, 457–460.
PubMed | open url image1

Grol R, Wensing M (2004) What drives change? Barriers to and incentives for achieving evidence-based practice. The Medical Journal of Australia 180, S57–S60.
PubMed | open url image1

Sawyer SM, Fardy HJ (2003) Bridging the gap between doctors’ and patients’ expectations of asthma management. The Journal of Asthma 40, 131–138.
Crossref | GoogleScholarGoogle Scholar | PubMed | open url image1

Sawyer SM, Shah S (2004) Improving asthma outcomes in harder-to-reach populations: challenges for clinical and community interventions. Paediatric Respiratory Reviews 5, 207–213.
Crossref | GoogleScholarGoogle Scholar | PubMed | open url image1

Shah S, Roydhouse JK, Sawyer SM (2008) Asthma education in primary healthcare settings. Current Opinion in Paediatrics 20, 705–710.
Crossref | GoogleScholarGoogle Scholar | PubMed | open url image1

Veale BM (2003) Meeting the challenge of chronic illness in general practice. The Medical Journal of Australia 179, 247–249.
PubMed | open url image1

Yates DH, Shah S, Veitch E, Thomas PS (2000) Teaching asthma management: an evidence-based educational approach. Australian and New Zealand Journal of Medicine 30, 33–37.
PubMed |  CAS | open url image1