dc.contributor.author	Julious, Steven A.
dc.contributor.author	Horspool, Michelle J.
dc.contributor.author	Davis, Sarah
dc.contributor.author	Franklin, Matthew
dc.contributor.author	Smithson, W. Henry
dc.contributor.author	Norman, Paul
dc.contributor.author	Simpson, Rebecca M.
dc.contributor.author	Elphick, Heather
dc.contributor.author	Bortolami, Oscar
dc.contributor.author	Cooper, Cindy
dc.contributor.funder	Health Technology Assessment Programme	en
dc.contributor.funder	Sheffield Clinical Commissioning Group	en
dc.date.accessioned	2019-07-16T16:01:39Z
dc.date.available	2019-07-16T16:01:39Z
dc.date.issued	2018-04-20
dc.description.abstract	Background Asthma is seasonal with peaks in exacerbation rates in school-age children associated with the return to school following the summer vacation. A drop in prescription collection in August is associated with an increase in the number of unscheduled contacts after the school return.Objective To assess whether a public health intervention delivered in general practice reduced unscheduled medical contacts in children with asthma.Design Cluster randomised trial with trial-based economic evaluation. Randomisation was at general practice level, stratified by size of practice. The intervention group received a letter from their general practitioner (GP) in late July outlining the importance of (re)taking asthma medication before the return to school. The control group was usual care.Setting General practices in England and Wales.Participants 12 179 school-age children in 142 general practices (70 randomised to intervention).Main outcome Proportion of children aged 5–16 years who had an unscheduled contact in September. Secondary endpoints included collection of prescriptions in August and medical contacts over 12 months (September–August). Economic endpoints were quality-adjusted life-years gained and health service costs.Results There was no evidence of effect (OR 1.09; 95% CI 0.96 to 1.25 against treatment) on unscheduled contacts in September. The intervention increased the proportion of children collecting a prescription in August by 4% (OR 1.43; 95% CI 1.24 to 1.64). The intervention also reduced the total number of medical contacts between September–August by 5% (incidence ratio 0.95; 95% CI 0.91 to 0.99).The mean reduction in medical contacts informed the health economics analyses. The intervention was estimated to save £36.07 per patient, with a high probability (96.3%) of being cost-saving.Conclusions The intervention succeeded in increasing children collecting prescriptions. It did not reduce unscheduled care in September (the primary outcome), but in the year following the intervention, it reduced the total number of medical contacts.Trial registration number ISRCTN03000938.	en
dc.description.sponsorship	Health Technology Assessment Programme (Grant 11/01/10)	en
dc.description.status	Peer reviewed	en
dc.description.version	Published Version	en
dc.format.mimetype	application/pdf	en
dc.identifier.articleid	e017367	en
dc.identifier.citation	Julious, S.A., Horspool, M.J., Davis, S., Franklin, M., Smithson, W.H., Norman, P., Simpson, R.M., Elphick, H., Bortolami, O. and Cooper, C., 2018. Open-label, cluster randomised controlled trial and economic evaluation of a brief letter from a GP on unscheduled medical contacts associated with the start of the school year: the PLEASANT trial. BMJ open, 8(4): e017367. DOI: 10.1136/bmjopen-2017-017367	en
dc.identifier.doi	10.1136/bmjopen-2017-017367	en
dc.identifier.eissn	2044-6055
dc.identifier.endpage	11	en
dc.identifier.issued	4	en
dc.identifier.journaltitle	BMJ Open	en
dc.identifier.startpage	1	en
dc.identifier.uri	https://hdl.handle.net/10468/8178
dc.identifier.volume	8	en
dc.language.iso	en	en
dc.publisher	BMJ Publishing Group	en
dc.relation.uri	https://bmjopen.bmj.com/content/8/4/e017367
dc.rights	© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/	en
dc.rights.uri	https://creativecommons.org/licenses/by/4.0/	en
dc.subject	Asmtha	en
dc.subject	Public health intervention	en
dc.subject	General practice	en
dc.subject	Scool-age children	en
dc.title	Open-label, cluster randomised controlled trial and economic evaluation of a brief letter from a GP on unscheduled medical contacts associated with the start of the school year: the PLEASANT trial	en
dc.type	Article (peer-reviewed)	en

Open-label, cluster randomised controlled trial and economic evaluation of a brief letter from a GP on unscheduled medical contacts associated with the start of the school year: the PLEASANT trial

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