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Research

Self-management interventions to reduce healthcare use and improve quality of life among patients with asthma: systematic review and network meta-analysis

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2521 (Published 18 August 2020) Cite this as: BMJ 2020;370:m2521

Linked Opinion

Asthma can take over your life, but the right support makes it easier

Rapid Response:

Are group consultations the way to reduce healthcare use and improve quality of life among patients with asthma?

Dear Editor,

I was really interested in the results of Hodkinson et al.'s systematic review on self-management interventions for patients with asthma. Their review concludes that supported self-management works to improve quality of life and reduce healthcare use but that patients need at least 2 hours investment of time to develop skills in self-management. In UK general practice, most asthma patients receive an annual review lasting about 20 minutes. Might this be the reason why the care of so many asthma patients is still sub-optimal? (1)

Practically, it would be almost impossible to invest 2 hours with patients on an individual basis, even if this was a non-recurring investment. Which leads me to wonder if we should seriously consider group consultations for the majority of patients with asthma? There is emerging evidence that group consultations may improve patient outcomes in a time-efficient way and are acceptable to many patients (2). I expect many practices would be willing to try if we could access some initial support and training.

1. Asthma UK. The Reality of Asthma Care in the UK. 2018. https://www.asthma.org.uk/578f5bcf/globalassets/get-involved/external-af...

2. Booth A, Cantrell A, Preston L, Chambers D, Goyder E. What is the evidence for the effectiveness, appropriateness and feasibility of group clinics for patients with chronic conditions? A systematic review. Southampton (UK): NIHR Journals Library; December 2015.

Competing interests: No competing interests

16 September 2020
Aarti Bansal
GP
Burngreave Surgery, Sheffield
5 Burngreave Rd, Sheffield S3 9DA