Nurse-led care for children with asthma in primary care: results of a randomised controlled trial
In brief
Nurse-led care raises asthma control test scores in children over 18 months
In a cluster trial of 90 kids aged 6-12, those receiving protocolled nurse visits (average two visits per child) showed consistently higher Childhood Asthma Control Test scores than usual care, with statistically significant gaps at 6, 12 and 18 months. The improvement suggests nurse-led follow-up can enhance control in primary-care settings, though long-term outcomes remain to be studied.
- Journal
- ERJ open research (Q1)
- Published
- 24 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Sara Bousema, Arthur M Bohnen, Dimitris Rizopoulos, Mariëlle W Pijnenburg, Patrick J E Bindels, Gijs Elshout
- PMID
- 42639026
- DOI
- 10.1183/23120541.01399-2025
Why clinicians should know about it
- Picked for Pulmonary and Respiratory Medicine (top studies of the week, 30 August 2026).
- Picked for Family Practice (paper of the day, 26 August 2026): Cluster RCT, improves asthma control in children
Abstract
BACKGROUND: Asthma is the most common chronic illness among children in primary care, causing a significant burden. While nurse-led care has proven effective in secondary and tertiary care, its impact in primary care remains unclear. The aim of the present study was to evaluate the effectiveness of protocolled nurse-led care (PC) versus usual care (UC) on asthma control in children with asthma in primary care. METHODS: This was a cluster randomised controlled trial with 18 months' follow-up including children aged 6-12 years with asthma in primary care. Children prescribed inhaled corticosteroids (ICS) at least once, or at least two short-acting β-agonist (SABA) prescriptions, or had at least one SABA prescription combined with an International Classification of Primary Care 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: 49 practices enrolled 90 patients (63.3% male, mean age 9.6 years, median C-ACT 23 (interquartile range 5.0)). 51 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: PC significantly improves asthma control in children aged 6-12 years in primary care, with a feasible number of nurse visits.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.