Background Asthma is the most common chronic illness among children in primary care, causing significant burden. While nurse-led care has proven effective in secondary and tertiary care, its impact in primary care remains unclear. Aim To evaluate the effectiveness of protocolled nurse-led care (PC) versus usual care (UC) on asthma control in children with asthma in primary care. Design and setting A cluster randomised controlled trial with 18 months’ follow-up including children aged 6–12 years with asthma in primary care. Methods Children prescribed inhaled corticosteroids (ICS) at least once, or ≥2 short-acting beta-agonist (SABA) prescriptions, or had ≥1 SABA prescription combined with an International Classification of Primary Care ( ICPC) code for asthma or bronchial spasm within the past year were eligible for inclusion. Clusters were randomised to PC or UC. The primary outcome was change in Childhood Asthma Control Test (C-ACT) scores. Secondary outcomes included uncontrolled asthma rates, quality of life, exacerbations, spirometry, and care satisfaction. Results Forty-nine practices enrolled 90 patients (63.3% male, mean age 9.6 years, median C-ACT 23 IQR 5.0). Fifty-one children received PC and 39 UC. C-ACT scores were consistently higher in the PC group, with significant differences at 6 (p=0.044), 12 (p=0.031), and 18 months (p=0.045). Median nurse review visits were 2 (range 0–6) per child. Conclusion Protocolled nurse-led care significantly improves asthma control in children aged 6–12 years in primary care, with a feasible number of nurse visits.
Bousema et al. (Thu,) studied this question.