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The asthma consultation: what is important?

Sufficient time and effective communication are the main requirements in an ideal asthma consultation. One way of using limited time effectively is for patients to be offered more information prior to the consultation. Physician-patient communication during the consultation may be improved by patients receiving, in advance, pertinent information related to their appointment and leaflets may be used to encourage patients to list any questions, fears or concerns prior to the consultation. Directing patients to appropriate internet sites may also facilitate information transfer. Time is frequently wasted when patients fail to attend their consultation. Sending a reminder letter or phoning to remind patients of their appointment has been shown to significantly reduce non-attendance rates. During the consultation, time can be used more effectively by ensuring that patients understand their treatment regimens, by improving communication between the doctor and patient and by organising asthma services in a manner acceptable to patients; this includes avoiding delays, having a doctor that listens and seeing the same doctor on each occasion. After the consultation, advice given to patients should be reinforced as studies suggest that patients' ability to recall information given to them may influence patient adherence and patient satisfaction. The whole professional team should be involved in order to manage better limited time effectively and information given to patients should be reinforced, either by post-consultation leaflet/letter or via telephone or email. Most importantly, correct performance of the inhalation manoeuvre should be regularly checked, patients should be taught and trained how to manage their own condition and should be offered convenient follow-up options, all of which should improve patient satisfaction and compliance.

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