Routine telephone review of asthma: Further investigation is  required

doi:10.1136/bmj.326.7401.1267-b

BMJ 2003;326:1267 (7 June), doi:10.1136/bmj.326.7401.1267-b

Letter

Routine telephone review of asthma

Further investigation is required

The first 150 words of the full text of this article appear below.

EDITOR—Pinnock et al conclude that telephone consultation for asthma review is an efficient option for patients in primary care.¹ We have several concerns about this study.

Firstly, a large number of patients (654/932) chose not to takepart, and a further 307 were excluded for other reasons. Itis not inconceivable that patients who dislike telephone consultationscould have entirely opted out even before the study started.

Secondly, the assumption that actual observation of patients'inhaler technique and peak flow measurement is equivalent toasking patients about their technique or measurements causesconcerns. Patients commonly deny problems using inhalers butoften fail to demonstrate effective usage.

Thirdly, the conclusion that both interventions were equallyeffective is somewhat spurious since, using their own instrument.neither intervention produced a difference in outcome threemonths later. It might be better to say both were equally ineffectual.

Lastly we found in our . . . [Full text of this article]

Brian McKinstry, senior researcher

Community Health Sciences, Edinburgh University, Edinburgh EH8 9DZ

David Heaney, senior researcher

Highlands and Islands Health Research Institute, University of Aberdeen, Beechwood Business Park North, Inverness IV2 3ED

Jeremy Walker, research fellow

Research Unit in Health, Behaviour and Change, University of Edinburgh, Medical School, Edinburgh EH8 9AG

Sally Wyke, director, Scottish School of Primary Care

Lister Institute, Edinburgh EH8 9DR

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Accessibility, acceptability, and effectiveness in primary care of routine telephone review of asthma: pragmatic, randomised controlled trial: Hilary Pinnock, Robert Bawden, Stephen Proctor, Stephanie Wolfe, Jane Scullion, David Price, and Aziz Sheikh
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