Our Asthma evaluation approach

The delivery of high-quality care and associated healthcare outcomes, in any healthcare system, is entirely dependent upon the implementation of guidelines. There are effectively two aspects in relation to the delivery of evidenced based guidelines:

The creation of the guidelines themselves.

The implementation of the guidelines.

LungHealth is focussing their support around the implementation (2) of the guidelines and that is the purpose of our Computer Guided Consultation (CGC) for Asthma. LungHealth has created a product that assists specialist and non-specialist healthcare professionals to deliver a full and thorough guideline level review, for all patients with an existing diagnosis of Asthma.

Does use of the CGC alter the clinical plan for the patient toward best care as defined by guidelines? To assess the effect of using the CGC we compared:

Standard care before and after the LungHealth CGC versus the care being recommended following the LungHealth CGC.

This is not a study of health outcomes but of the processes of care being offered to patients. 

Guidelines advice, based on best evidence, is that there are direct benefits from ensuring the following elements of care are incorporated into an Asthma review:

• An accurate diagnosis

• An assessment of asthma control

• A review of adherence to treatment

• An inhaler technique assessment to ensure that the patient can use their inhaler correctly

• Correct drug treatment in line with the patient's disease severity

• Ensure that the patient receives a written personal asthma action plan (PAAP)

• Identification of those patients at risk of adverse Asthma outcomes and emergency unscheduled healthcare utilisation

• Referral to specialist services in line with BTS/SIGN guidelines

The assessment of care at the start of the CGC explores whether the above actions have been documented in the patient’s historical record.

During the CGC review, the clinician is prompted to consider each of the modifiable aspects of care. It remains up to the clinician and indeed the patient to decide whether to follow the prompt or not (note some patients will decline what is on offer and that is their right).  

It is the analysis of the before and after changes in the patient clinical records that allows for our evaluation.

Statistical evaluation shows that the changes made at a LungHealth consultation are highly statistically significant.

We have performed a series of evaluations over the last few years comparing care before and after the CGC and presented these to our clinical colleagues in UK, Europe and the U.S. The summary of these presentations is included in our Resources section.

We use the standard definitions of significance i.e. that a p value of <0.05 is significant but a value of <0.001 is highly significant i.e. most unlikely to be a chance observation.