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Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Asthma imposes a substantial burden on individuals and societies. Patients with asthma need high-quality primary care management; however, evidence suggests the quality of this care can be highly variable. Here we identify and report factors contributing to high-quality management. Twelve primary care global asthma experts, representing nine countries, identified key factors. A literature review (past 10 years) was performed to validate or refute the expert viewpoint. Key driving factors identified were: policy, clinical guidelines, rewards for performance, practice organisation and workforce. Further analysis established the relevant factor components. Review evidence supported the validity of each driver; however, impact on patient outcomes was uncertain. Single interventions (e.g. healthcare practitioner education) showed little effect; interventions driven by national policy (e.g. incentive schemes and teamworking) were more effective. The panel\u2019s opinion, supported by literature review, concluded that multiple primary care interventions offer greater benefit than any single intervention in asthma management.<\/jats:p>","DOI":"10.1038\/s41533-020-0184-0","type":"journal-article","created":{"date-parts":[[2020,6,17]],"date-time":"2020-06-17T10:05:00Z","timestamp":1592388300000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Improving primary care management of asthma: do we know what really works?"],"prefix":"10.1038","volume":"30","author":[{"given":"Monica J.","family":"Fletcher","sequence":"first","affiliation":[]},{"given":"Ioanna","family":"Tsiligianni","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2760-0693","authenticated-orcid":false,"given":"Janwillem W. 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M.F. and T.v.d.M. are former employees of GlaxoSmithKline plc., and M.F. holds stocks in GlaxoSmithKline plc. I.T. reports advisory boards from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline plc. and Novartis and a grant from GlaxoSmithKline Greece, outside the submitted work. J.K. reports grants and personal fees from AstraZeneca, grants and personal fees from Boehringer Ingelheim, grants from Chiesi, grants and personal fees from GlaxoSmithKline plc., grants and personal fees from Novartis, grants from Mundipharma, grants from TEVA, outside the submitted work. A.C. reports a grant from AstraZeneca for an asthma study. C.C. reports grants from Pfizer China, outside of the submitted work. M.T. reports the following conflicts of interest: neither M.T. nor any member of his close family has any shares in pharmaceutical companies; receipt in the last 3 years of speaker\u2019s honoraria for speaking at sponsored meetings or satellite symposia at conferences from GlaxoSmithKline plc. and Novartis, companies marketing respiratory and allergy products; receipt of honoraria for attending advisory panels with Boehringer Inglehiem, GlaxoSmithKline plc. and Novartis; membership of the BTS SIGN Asthma guideline steering group and the NICE Asthma Diagnosis and Monitoring guideline development group. P.K. reports personal fees from AstraZeneca, GlaxoSmithKline plc., Chiesi, Menarini, Novartis, Klosterfrau, Bionorica, Willmar Schwabe and MSD, and other support (for a phase 3 investigator cough study) from MSD, all outside the submitted work. C.S. has no shares in any pharmaceutical companies, she has received consultant agreements and honoraria for presentations from several pharmaceutical companies that market inhaled medication including AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline plc., Napp Pharmaceuticals and Teva. J.C.d.S. reports personal fees and speaker\u2019s honoraria from Boheringer Ingelheim, personal fees and speaker\u2019s honoraria from GlaxoSmithKline plc., personal fees and speaker\u2019s honoraria from AstraZeneca, personal fees and speaker\u2019s honoraria from Mundipharma outside the submitted work. M.R.R. reports personal fees from AstraZeneca, personal fees from Boehringer Ingelheim, personal fees from Chiesi, grants and personal fees from GlaxoSmithKline plc., personal fees from Menarini, personal fees from Mundipharma, personal fees from Novartis, personal fees from Pfizer, personal fees from Teva, personal fees from Bial, outside the submitted work. E.M.K. received honoraria for attending advisory board meeting from GlaxoSmithKline plc., Boehringer Inglehiem and grant from Novartis outside the submitted work.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"29"}}