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OBJECTIVES: To describe nurse-led UK general practice asthma and chronic obstructive pulmonary disease (COPD) care, and the training undertaken to support it. METHODS: Questionnaires were sent to 500 randomly-selected UK asthma and COPD practice nurses. RESULTS: 382 nurses (76%) completed the practice characteristics section, 389 (78%) described their asthma roles and training, and 368 (74%) described their COPD roles and training. 96 practices (25%; 95%CI 21–29%) ran designated asthma clinics, 87 (23%; 95%CI 19–27%) ran designated COPD clinics, and 170 (45%; 95%CI 40–49%) did not run designated respiratory clinics. Of the 255 nurses with an advanced asthma role, 51 (20%; 95%CI 15–25%) did not have accredited asthma training. Of the 215 nurses with an advanced COPD role, 111 (52%; 95%CI 45–58%) did not have accredited COPD training. CONCLUSION: Patients are increasingly being seen outside of designated asthma or COPD clinics, often by nurses with an advanced role. It is important that nurses have the training to fulfil this role.

Background: Non-adherence to corticosteroid treatment has been shown to reduce treatment efficacy, thus compromising asthma control. Aims: To examine the experiences of treatment side effects, treatment concerns and adherence to inhaled (ICS) and oral corticosteroids (OCS) among people with asthma and to identify the degree of concordance between clinician estimates of side effects and the prevalence reported by patients. Methods: Asthma UK members were sent validated questionnaires assessing treatment concerns, experiences of side effects and adherence. Questionnaires measuring clinicians’ estimates of the prevalence of corticosteroid side effects were completed online. Results: Completed questionnaires were returned by 1,524 people taking ICS, 233 taking OCS and 244 clinicians (67% of clinicians were primary care nurses). Among people with asthma, 64% of those taking ICS and 88% of those taking OCS reported ⩾1 side effect. People reporting high adherence to ICS (t=−3.09, Pt=1.86, Pr=0.46, Pr=0.50, Pt=6.90, Pt=1.71; P Conclusions: An unexpectedly large proportion of people with asthma experienced side effects and had strong concerns about their treatment, which compromised adherence. These findings have implications for the design of interventions to optimise asthma control through improved adherence.

Re: Thomas M et al . Prim Care Resp J 2009;18(2):83–88 Assessing asthma control using the RCP 3 questions