PDF(Pubmed)
Abstract：
Every year, there are ~100,000 hospital admissions for asthma in the UK, many of which are potentially preventable. Evidence suggests that carefully conceptualised and implemented audit and feedback (A&F) cycles have the potential to improve clinical outcomes for those with chronic conditions. We wanted to investigate the technical feasibility of developing a near-real time asthma dashboard to support A&F interventions for asthma management in primary care. We extracted cross-sectional data on asthma from 756 participating GP practices in the Oxford-Royal College of General Practitioners Research and Surveillance Centre (RCGP RSC) database in England comprising 7.6 million registered people. Summary indicators for a GP practice were compared to all participating RCGP RSC practices using practice-level data, for the week 6-12th-Mar-2023. A weekly, automated asthma dashboard with features that can support electronic-A&F cycles that compared key asthma indicators for a GP practice to RCGP RSC could be created ( https://tinyurl.com/3ydtrt85 ): 12-weeks-incidence 0.4% vs 0.4%, annual prevalence 6.1% vs 6.7%, inhaled relievers to preventer 1.2 vs 1.1, self-management plan given 83.4% vs 60.8%, annual reviews 36.8% vs 57.3%, prednisolone prescriptions 2.0% vs 3.2%, influenza vaccination 56.6% vs 55.5%, pneumococcal vaccination ever (aged ≥65 years) 90.2% vs 84.1% and current smokers 14.9% vs 14.8%. Across the RCGP RSC, the rate of hospitalisations was 0.024%; comparative data had to be suppressed for the study practice because of small numbers. We have successfully created an automated near real-time asthma dashboard that can be used to support A&F initiatives to improve asthma care and outcomes in primary care.
摘要：
每年,在英国，有大约100,000名哮喘患者入院，其中许多是可以预防的。证据表明，仔细概念化和实施的审核和反馈（A＆F）周期有可能改善慢性病患者的临床结果。我们希望研究开发近实时哮喘仪表板以支持初级保健中哮喘管理的A＆F干预措施的技术可行性。我们从英国牛津-皇家全科医师研究与监测中心（RCGPRSC）数据库中的756名参与GP实践中提取了哮喘的横截面数据，该数据库包括760万注册人。使用实践级别数据将GP实践的汇总指标与所有参与RCGPRSC实践进行比较，2023年3月6日至12日一周。每周一次，可以创建具有可支持电子A＆F周期的功能的自动哮喘仪表板，将GP实践的关键哮喘指标与RCGPRSC进行比较（https://tinyurl.com/3ydtrt85）：12周发病率0.4％vs0.4％，年患病率6.1%对6.7%，预防性吸入缓解剂1.2比1.1，自我管理计划给予83.4%比60.8%，年度评审分别为36.8%和57.3%，泼尼松龙处方2.0%vs3.2%，流感疫苗接种56.6%和55.5%，曾经接种过肺炎球菌疫苗（年龄≥65岁）90.2%vs84.1%，目前吸烟者14.9%vs14.8%。整个RCGPRSC,住院率为0.024%;由于病例较少,必须抑制对比数据进行研究.我们已经成功创建了一个自动化的近实时哮喘仪表板，可用于支持A＆F计划，以改善初级保健中的哮喘护理和结果。
