How Better Primary Care Could Cut Asthma and COPD Emergencies in Half

Better management in primary care can dramatically reduce the number of asthma and chronic obstructive pulmonary disease (COPD) emergencies that send people to the hospital. A new study from Australia found that when general practitioners (GPs) use electronic health records to identify high-risk patients and proactively adjust their care, serious flare-ups plummet—and these improvements last for years, not just weeks.

What Happens When GPs Get Better Tools to Manage Asthma and COPD?

Asthma and COPD together affect more than 13% of Australians, yet many of the most serious attacks that land people in emergency departments are actually preventable with smarter care planning. Researchers at the Institute for Respiratory Health evaluated a program called ACAER (Achieving Clinical Audits with Electronic Records), developed by Optimum Patient Care Australia. The program works by automatically scanning patients' existing electronic health records to flag those at highest risk of a serious exacerbation, then prompting GPs to review and adjust their medications and care plans before a crisis happens.

The results were striking. The study tracked nearly 2,000 high-risk patients across 21 GP practices over multiple years. For high-risk asthma patients, monthly exacerbation rates dropped from 74.8 per 1,000 patients per month down to 32.4 per 1,000 patients per month—a reduction of more than 56%. For high-risk COPD patients, rates fell from 122.9 to 91.2 per 1,000 patients per month, a decrease of about 26%. Importantly, these improvements held steady over years of follow-up, showing this wasn't just a temporary bump.

How Did GPs Change Their Treatment Approach?

The intervention prompted widespread medication adjustments. In the first year after the program started, nearly half of high-risk asthma patients and more than half of high-risk COPD patients had their medications changed or optimized. These treatment adjustments appear to have directly contributed to fewer attacks and hospital visits.

The key changes included:

• Medication Reviews: GPs identified patients whose current inhalers or other respiratory medications weren't adequately controlling their symptoms and made adjustments before problems escalated.
• Risk Stratification: Electronic records helped pinpoint which patients were most vulnerable to serious flare-ups, allowing GPs to focus intensive support where it mattered most.
• Proactive Follow-up: Instead of waiting for patients to call with problems, GPs reached out to high-risk individuals to review their care plans and catch early warning signs.
• Long-term Monitoring: The system continued to track patients over years, ensuring that improvements in attack rates persisted and that new risks were caught early.

"The findings from this study highlight the crucial role of the Australian primary care system for enhancing the care of patients with asthma and COPD. Getting the basics right reduces the harm experienced by individuals from both exacerbations and their treatments, and helps take pressure off stretched emergency care services," said Professor John Blakey, Research Leader at the Institute for Respiratory Health and Head of the Department of Respiratory Medicine at Sir Charles Gairdner Hospital.

Why Does This Matter for Your Health and Healthcare System?

Emergency department visits and hospital stays for asthma and COPD flare-ups are costly, disruptive, and often frightening for patients. They also strain already-stretched emergency services. The new research suggests that many of these crises are avoidable if primary care providers have the right tools and information to manage these conditions proactively. Rather than waiting for patients to have a severe attack, GPs can use electronic health records to stay ahead of the problem.

The study was conducted in collaboration with Optimum Patient Care Australia and the Observational and Pragmatic Research Institute (OPRI), and published in the Journal of Asthma and Allergy. The findings reinforce what respiratory experts have long suspected: that the foundation of good asthma and COPD care happens in primary care, not in emergency rooms. When GPs have the data and support they need to make informed decisions, patients benefit from fewer attacks, better medication management, and fewer hospitalizations.