A randomised controlled trial of clinics in secondary schools for adolescents with asthma

Aim: To compare a nurse-led clinic in schools versus care in general practice for adolescents with asthma. Design of study. Randomised controlled trial in four schools,. parallel observational study in two schools Setting. Six comprehensive schools. method In the randomised trial, pupils were invited to attend asthma review at a nurse-led clinic either in school, or in general practice The parallel observational study compared pupils invited to practice care within and outside the randomised trial. as review, Primary outcome measures were attendance or asthma symptom control, and quality of life. Secondary outcomes were knowledge, attitudes, inhaler technique, use of steroids, school absence, peak flow rate, preference for future care, health service utilisation, and costs Results. School clinic pupils were more likely to attend an asthma review than those randomised to practice care (90,8916 versus 51.0% overall [P<0.001, not consistent across schools]). No differences were observed in symptom control (P = 0.42) or quality of life (P = 0. 63). Pupils attending school clinics had greater knowledge of asthma (difference = +0.38, 95% CI = 0. 19 to 0.56), more positive attitudes (difference = +0.21, 9596 CI = 0. 05 to 0.36), and better inhaler technique (P<0.001, not consistent across all schools). No differences were observed in school absence or peak flow rate. A majority (63%) of those who had received care at school preferred this model in future. Median costs of providing care at school and at the practice were pound32.10 and pound19.80, respectively. No differences were observed between the groups in the observational comparison on any outcome. Conclusions. The schools asthma clinic increased uptake of asthma reviews There were improvements in various process measures, hut not in clinical outcomes.