Skip to main content
The British Journal of General Practice logoLink to The British Journal of General Practice
. 1999 Jan;49(438):23–26.

Predictive value of a simple asthma morbidity index in a general practice population.

K Jones 1, R Cleary 1, M Hyland 1
PMCID: PMC1313312  PMID: 10622011

Abstract

BACKGROUND: There is a need in primary care for simple asthma outcome measures that are valid in terms of their relationship with lung function and capable of predicting those patients for whom additional management is indicated. AIM: To assess the predictive validity of a revised asthma morbidity index in United Kingdom (UK) general practice. METHOD: Morbidity index and peak flow rate data were gathered from nine general practices over a three-month period. Two postal questionnaire surveys, one year apart, were conducted in one Tyneside general practice. Morbidity index data from 570 asthmatic patients were gathered in the first survey and used to predict morbidity over the next year. RESULTS: For 120 responders with low morbidity, mean peak flow as a percentage of the predicted value was 91% (SD = 21%); for 91 responders with medium morbidity, the percentage was 77% (SD = 21%); and for 90 responders with high morbidity, it was 63% (SD = 29%). Fifty-seven per cent of the morbidity index categories remained unchanged after 12 months. The relative risks of high morbidity for having any acute asthma attacks, more than four attacks, and needing oral steroids during a one year period were 2.88 (CI = 1.87 to 4.43), 2.52 (CI = 1.84 to 3.44) and 2.38 (CI = 1.70 to 3.33) respectively. CONCLUSION: The revised morbidity index is a simple and valid tool for the opportunistic surveillance of asthma in primary care.

Full Text

The Full Text of this article is available as a PDF (44.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aveyard P. Assessing the performance of general practices caring for patients with asthma. Br J Gen Pract. 1997 Jul;47(420):423–426. [PMC free article] [PubMed] [Google Scholar]
  2. Dickinson J., Hutton S., Atkin A., Jones K. Reducing asthma morbidity in the community: the effect of a targeted nurse-run asthma clinic in an English general practice. Respir Med. 1997 Nov;91(10):634–640. doi: 10.1016/s0954-6111(97)90011-1. [DOI] [PubMed] [Google Scholar]
  3. Hyland M. E., Finnis S., Irvine S. H. A scale for assessing quality of life in adult asthma sufferers. J Psychosom Res. 1991;35(1):99–110. doi: 10.1016/0022-3999(91)90011-c. [DOI] [PubMed] [Google Scholar]
  4. Jones K. P., Bain D. J., Middleton M., Mullee M. A. Correlates of asthma morbidity in primary care. BMJ. 1992 Feb 8;304(6823):361–364. doi: 10.1136/bmj.304.6823.361. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Jones K. P., Charlton I. H., Middleton M., Preece W. J., Hill A. P. Targeting asthma care in general practice using a morbidity index. BMJ. 1992 May 23;304(6838):1353–1356. doi: 10.1136/bmj.304.6838.1353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Jones K. P., Mullee M. A. Proactive, nurse-run asthma care in general practice reduces asthma morbidity: scientific fact or medical assumption? Br J Gen Pract. 1995 Sep;45(398):497–499. [PMC free article] [PubMed] [Google Scholar]
  7. Jones P. W., Quirk F. H., Baveystock C. M., Littlejohns P. A self-complete measure of health status for chronic airflow limitation. The St. George's Respiratory Questionnaire. Am Rev Respir Dis. 1992 Jun;145(6):1321–1327. doi: 10.1164/ajrccm/145.6.1321. [DOI] [PubMed] [Google Scholar]
  8. Juniper E. F., Guyatt G. H., Epstein R. S., Ferrie P. J., Jaeschke R., Hiller T. K. Evaluation of impairment of health related quality of life in asthma: development of a questionnaire for use in clinical trials. Thorax. 1992 Feb;47(2):76–83. doi: 10.1136/thx.47.2.76. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Juniper E. F., Guyatt G. H., Ferrie P. J., Griffith L. E. Measuring quality of life in asthma. Am Rev Respir Dis. 1993 Apr;147(4):832–838. doi: 10.1164/ajrccm/147.4.832. [DOI] [PubMed] [Google Scholar]
  10. Neville R. G., Hoskins G., Smith B., Clark R. A. Observations on the structure, process and clinical outcomes of asthma care in general practice. Br J Gen Pract. 1996 Oct;46(411):583–587. [PMC free article] [PubMed] [Google Scholar]
  11. Santanello N. C., Barber B. L., Reiss T. F., Friedman B. S., Juniper E. F., Zhang J. Measurement characteristics of two asthma symptom diary scales for use in clinical trials. Eur Respir J. 1997 Mar;10(3):646–651. [PubMed] [Google Scholar]
  12. Steen N., Hutchinson A., McColl E., Eccles M. P., Hewison J., Meadows K. A., Blades S. M., Fowler P. Development of a symptom based outcome measure for asthma. BMJ. 1994 Oct 22;309(6961):1065–1068. doi: 10.1136/bmj.309.6961.1065. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Sterk P. J., Fabbri L. M., Quanjer P. H., Cockcroft D. W., O'Byrne P. M., Anderson S. D., Juniper E. F., Malo J. L. Airway responsiveness. Standardized challenge testing with pharmacological, physical and sensitizing stimuli in adults. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993 Mar;16:53–83. [PubMed] [Google Scholar]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

RESOURCES