A COMPARISON OF THE RESPIRATORY CARE GIVEN TO ASTHMATIC AND NONASTHMATIC CHILDREN IN A GENERAL-PRACTICE

Aim. To compare the management of respiratory problems in asthmatic an d nonasthmatic children. Method. A comparison of recorded morbidity in clinical records with parental replies to questionnaires for random m atched samples of 5 to 9 year old asthmatic and nonasthmatic children from a suburban middle class general practice over the 1990 year. Resu lts. Eighty six percent of parents of asthmatic children and 75% of pa rents of nonasthmatic children responded. 11% of asthmatic children le ft the practice without giving a forwarding address. Asthmatic childre n consulted more often, saw more general practitioners, and were presc ribed more antibiotic and asthma related drug items than nonasthmatic children. Asthmatic children were no more likely than nonasthmatic chi ldren to have their respiratory system examined at the general practic e when well and no more likely to use secondary services. Fifty seven percent of asthmatic children had an asthma drug related prescription written and 22% of asthmatic children had a peak flow recording. Disag reement between records and parental report: 31% of nonasthmatic child ren were reported by parents to have asthma related symptoms. 31% of t hese children did not see a general practitioner, 31% were seen for ot her problems, and 38% were treated for respiratory problems but not di agnosed as asthmatic. Forty nine percent of asthmatic children were re ported to be taking daily asthma medication but 38% of these children had not been prescribed their medication in the practice. Fifty one pe rcent of asthmatic children were reported not to be taking daily asthm a medication but 50% of these children had been prescribed an asthma d rug in the practice. Conclusion. Asthmatic and nonasthmatic children h ave nearly all their respiratory illnesses managed in general practice . In the general practice management of asthma the issues of workload, continuity of care, acute management, practice population based manag ement, and communication need more research.