Improving general practice care of patients with asthma or chronic obstructive pulmonary disease: evaluation of a quality system.

RESULTS. The percentage of patients who had two or more consultations per year increased significantly in the intervention practices (median, 27% of patients before the intervention vs 82% of patients after the intervention; P < 0.01), as did the per- centage of patients who had at least one measurement of peak expiratory flow rate (median, 10% of patients before the intervention vs 84% of patients after the inter- vention; P < 0.01). The percentage of patients who received a prescription for anti- inflammatory agents did not increase significantly. No significant changes were seen in the control practices. Physicians in the intervention practices were more likely to monitor medication compliance and inhalation technique. No difference was found in frequency of influenza vaccination. CONCLUSION. The quality system improved guideline compliance in some areas but not in others.