The situation pre 1987

The situation pre-1987

It is difficult for current healthcare professionals to appreciate how much the management of respiratory diseases in primary care has changed over the last 30-40 years. Prior to 1987 there were no national asthma or COPD guidelines, very few (if any) structured asthma clinics or asthma nurses in general practice, and almost all patients with any significant respiratory disease were managed long-term in a hospital setting. For most GPs and primary care nurses, contact with an asthma or COPD patient usually occurred because of an acute severe attack which required emergency treatment, and there was little structured primary care follow-up of these patients. In general there was a lack of awareness of most respiratory diseases in primary care, and under-diagnosis and under-treatment was common. 

However, there were several research groups and GPs making significant contributions to the published literature at this time, and in 1987 the Royal College of GPs (RCGP) published the first primary care asthma guideline (or ‘protocol’) for GPs. In the same year six respiratory-interested UK GPs formed the ‘GPs in Asthma Group’ (GPIAG). The function of this primary care special-interest group was to raise the profile of, and interest in, general practice management of asthma.