Asthma is a very common disease that can occur at any age. In the UK and in many other countries it is mainly managed in primary care. The published evidence suggests that the key to improving diagnosis and management lies in better training and education rather than in the discovery of new medications. An asthma improvement project managed through the British Lung Foundation is attempting to do this. The project has three pilot sites: two in England supported by the Department of Health and one in Scotland supported by the Scottish Government. If the project is successful it will be rolled out to other health areas within the UK. The results of this project are not yet available. This article highlights the challenges encountered in setting up the project and may well be applicable to other areas in the UK and to other countries where similar healthcare systems exist. The encountered challenges reflect the complex nature of healthcare systems and electronic data capture in primary care. We discuss the differences between general practices in their ability and willingness to support the project, the training and education of their staff on asthma management, governance issues in relation to information technology systems, and the quality of data capture. Virtually all the challenges have now been overcome, but discussing them should ensure that others become aware of them at an early stage should they wish to undertake similar projects in the future.
Our thanks to all practice and primary care staff in North Staffordshire, Stoke-on-Trent and Grampian health areas who have given their valuable time to this project, as well as to all team members of Optimal Patient Care who have applied their expertise in helping interrogate the practice IT systems and supply the reports for the individual practices. We thank various colleagues in secondary care and particularly the support we have had from the British Lung Foundation. Finally we thank the generosity of the DoH in England and the Scottish Government for funding the projects.