Table 3 Changes in asthma management during the programme.

	1993	2004
Primary care
General practitioner	Asthma suspicion referred to specialist without lung function testsInfrequent follow up visitsPrescriptions renewed without check up	Diagnosis of asthma by GPShort specialist consultation as neededAnti‐inflammatory treatment started without delayEasy access to evidence based guidelines and local treatment chainsAnnual follow up visits
Nurse	Rarely spirometry measurements made or peak flow values followed	Daily spirometry measurementsRoutine guidance in peak flow measurement and use of inhalersPatient centred asthma education with written action planAnnual follow up visits
Specialist care
Adults	Diagnosis of asthma	Only a portion of new diagnoses
	Most follow up visits	Follow up of severe cases only
	Emergency care	Part of emergency care
Children	Diagnosis, treatment, follow up of all childhood asthmaInpatient treatment of acute asthma	Diagnosis of childhood asthmaTreatment, follow up of preschool asthmaInpatient treatment of acute asthma
	1997	2004
Pharmacies
Asthma coordinators	No actively organised role in asthma care	Active guidance in use of preventers and relievers; guidance in inhalation technique
		Networking with local health care