Why don't patients attend the asthma clinic?

Abstract

Aims: To find out why asthma patients do not attend for structured nurse-led asthma care in a general practice. A secondary aim was to look at some of the morbidity characteristics of these patients. Method: A telephone questionnaire was administered by practice nurses to asthma clinic non-attenders (to parents of non-attenders age 5-16). Results: Out of 578 asthmatic patients over the age of 5 (practice list = 6300), 357 were 'non-attenders'. Of these, 225 (63%) perceived that they no longer had asthma or that their asthma was not serious enough to warrant a routine checkup. 106 patients (30%) saw their own GP instead. Logistical reasons for non-attendance such as timing of appointments and difficulty with transport accounted for less than 6% of patients. The 'low perceivers' had significantly lower morbidity, night-time waking and oral steroid usage than the group as a whole, but the patients only seeing their GP exhibited significantly higher morbidity for the same parameters. Conclusions: In our asthma-interested practice there are a high number of asthma clinic non-attenders. The main reasons for non-attendance are low perception of asthma severity and patients seeing their own GP. The latter group have a relatively higher level of asthma morbidity. These results suggest that asthma management in primary care needs to involve all doctors in a practice and cannot be left to the asthma clinic alone.