Greenwich asthma study

BMJ 1999;319:709- ( 11 September )

Letters

Greenwich asthma study

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EDITOR $---$ Premaratne et al's study highlights the difficulties encountered in implementing the British Thoracic Society's guidelinesfor asthma in Greenwich,¹ an inner city area which has a highincidence of urban deprivation with all its attendant problemsknown to have an impact on asthma and quality of life.²

When this study took place there was an explosion of asthma education for practice nurses, and it would have been useful tocompare asthma knowledge and services within the control and interventiongroups. The authors acknowledge that an initiative by the area'sfamily health services authority, targeting the underuse of inhaledsteroids in general practice, affected general practitioners'prescribing and that an unusually high turnover of practice nurseswithin the intervention group had an impact on the service provided.In view of these influences it seems unlikely that the controlgroup was untainted, and the study results become difficult tointerpret.

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Feder, G., Griffiths, C., Foster, G., Ahmed, S., Maclaren, D., Carter, Y., Premaratne, U N, Sterne, J A C, Burney, P G J, Marks, G B, Webb, J R (2000). Greenwich asthma study. BMJ 320: 580-580 [Full text]
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