[As supplied by authors] ELECTRA: East London Controlled Trial for High-risk Asthma

Protocol for intervention and control groups

INTERVENTION	CONTROL
PATIENT	PATIENT
FIRST CLINIC VISIT Inhaler technique check Education based on previous admission / AED attendance as ‘critical incident’ to focus on behaviour change. Guided self management using PEF thresholds (see main paper). National Asthma Campaign (NAC) Self management Plan leaflet and completed credit card NAC asthma leaflet (translations as appropriate) Give PEF meter Give home rescue oral steroids if appropriate	CLINIC VISIT Inhaler technique check Asthma Leaflet Patients over 8 years give PEF meter for diary
FOLLOW UP VISIT (by phone, unless specific reason for face to face): Review of self management	N/A
LIAISON WITH PRACTICE: Phone practice nurse re patient Letter giving outline of education given and request for follow up	Usual AED / discharge information Clinic letters as appropriate
PRACTICE	PRACTICE
FIRST EDUCATIONAL VISIT Aim for GPs and practice nurses to be present, and practice manager if possible Convey concept of high risk patient Discuss laminate sheet of high risk asthma guidelines Start high risk register half dozen pts - aim for box or computer register Discuss guided self management Equipment - bring spacers, MDI, and oral steroids + placebos if needed. Agree method of follow up	SINGLE EDUCATIONAL VISIT to discuss standard East London Asthma Guidelines.
SECOND EDUCATIONAL VISIT Consolidate high risk asthma register and follow up plans
FURTHER LIAISON As necessary, dictated in discussion with practice