Measuring success in asthma care: a repeat audit.

An asthma audit was first performed in 1984 in a two-doctor semi-rural training practice in Shroshire with 4400 patients. This paper reports on a repeat of the audit in 1987 in the same practice, following a programme of minimal intervention. Interviews were conducted with 192 asthmatics, 96% of those known to the practice on a manual register. Between the 1984 and 1987 audits there was a significant increase in ownership of peak flow meters and their use for monitoring progress and an improvement in inhaler technique. There was a general improvement in patients' knowledge about asthma. Inadequate control was shown in 22% of the sample in 1987, but half of these patients were known to be non-compliant. There were significant improvements in scores for asthma disability in night-time symptoms in children (P less than 0.05) and in daytime symptoms in adults (P less than 0.001) between 1984 and 1987. It is concluded that improved levels of asthma care have been achieved in a small practice using checklists, booklets and repeated audit, but without structured follow up or an asthma clinic.