Box 3. Intervention outline.

Tasks Diagnose on the basis of history and clinical examination Register patient (complete chronic disease card) 1. Prescribe drugs, according to the disease condition (as per desk-guide) Asthma Use short acting inhaled beta-2 agonist salbutamol (SABA) for quick relief (as required) Administer beclomethasone inhaler twice a day Change to beclomethasone + formeterol combination if symptoms remain uncontrolled Add montelukast or theophylline if symptoms remain uncontrolled Add oral steroid if symptoms remain uncontrolled COPD Start with SABA or short acting muscarine antagonist (SAMA) inhaler Change to SABA and SAMA combination if symptoms remain uncontrolled Change to long acting beta-2 agonist (LABA) + steroid combination if symptoms remain uncontrolled Add long-acting muscarine antagonist LAMA or oral theophylline to LABA + steroid combination if symptoms remain uncontrolled 2. Counsel the patient, using a pictorial tool, for prevention and treatment adherence 3. Examine (clinical), prescribe (and dispense), and record, as per desk-guide, on each monthly follow-up visit 4. Identify and retrieve those found with a delay in their monthly follow-up visit (three-tray system to identify; and a mobile phone to communicate with such patients)

The two tasks (a and b) were common for all asthma and COPD patients. The four tasks (1–4) differed in the intervention and control arms (as per desk-guide in the intervention, and as per doctor routine in the control). LABA = long acting beta-2 agonist. LAMA = long-acting muscarine antagonist. SABA =short-acting inhaled beta-2 agonist. SAMA = short-acting muscarine antagonist.