Ariel Washington, Lisa Smith, Jill Randall, Georgia Anderson
A Systematic Review of the Effectiveness of Cervical Cancer Screening and Prevention Interventions for African American Women: Implications for Promoting Health Equity
Journal of women's health (2002)
biologic treatments alleviate severe asthma symptoms reduce health service use however service capacity limits low referral rates primary care indicate unmet patient need report mixedmethods evaluation enhanced severe asthma pathway implemented staffordshire stokeontrent uk aimed optimise primary care referrals trainingeducation increased capacity specialist clinics quantitative analysis assessed patient wait times pathway stages prescribing changes exacerbations hospital admissions asthma control interviews 12 stakeholders evaluated perceptions enhanced pathway across settings 12 months 564 patients 28 general practices reviewed biologics eligibility 125 222 referred specialist assessment wait times significantly lower enhanced pathway compared historic patients following standard pathway reduced overall mean 764 267 weeks referral biologics initiation p 0001 patients commencing biologics n 46 showed significantly reduced reliever inhaler prescribing rates p 0037 60 lower oral steroid use p 0001 significantly reduced exacerbation rates p 0001 fewer hospital admissions p 0001 compared 12 months pretreatment mean asthma control scores reduced 313 preinitiation 189 postinitiation p 0001 clinically significant improvement interviewees viewed enhanced pathway positively although ongoing issues related difficulties engaging primary care amid concerns around increased workloads pathway capacity large number referrals generated comparatively small number general practices confirms substantial unmet need enhanced severe asthma pathway could help address implemented routinely