0
Abstract: Slide Presentations |

Physician Specialty as a Key Determinant of Guidelines-Based Asthma Care FREE TO VIEW

Richard A. Feifer, MD; Mona Khalid, MBA; Jeffrey Abraham, MBA; Susan J. Rappaport, MPH; Lauren Berger, MPH; Ronald E. Aubert, PhD
Author and Funding Information

Medco Health Solutions, Franklin Lakes, NJ


Chest


Chest. 2003;124(4_MeetingAbstracts):95S. doi:10.1378/chest.124.4_MeetingAbstracts.95S-a
Text Size: A A A
Published online

Abstract

PURPOSE:  National Asthma Education and Prevention Program (NAEPP) guidelines recommend therapy based on structured severity stratifications for each patient, and written action plans with self-monitoring of peak flows. Nevertheless, many patients do not receive guideline-based care. This study surveyed physicians treating asthma patients to identify significant differences in guidelines-based care across specialties.

METHODS:  A 4-page survey (with a $1 response-incentive) was mailed to 3,000 physicians, representing a random sample of those treating patients enrolled in a large asthma disease management program.

RESULTS:  Responses from 348 physicians were received, representing 17% general internists, 41% family physicians, 18% pediatricians, 9% pulmonologists, 11% allergists, and 4% alternate specialties.High familiarity with the NAEPP guidelines was reported significantly more often by pulmonologists (84%, p<0.0001), allergists (95%, p<0.0001), and pediatricians (74%, p<0.0001), compared with all other physicians (42%).High familiarity with NAEPP severity subtypes was also reported more often by pulmonologists (84%, p<0.0001), allergists (95%, p<0.0001), and pediatricians (75%, p<0.0001), compared with all other physicians (42%).Use of these NAEPP severity classifications to guide patient management for more than 60% of asthma visits was reported more often by pulmonologists (65%, p<0.0001), allergists (74%, p<0.0001), and pediatricians (66%, p<0.0001), compared with all other physicians (35%).Overall, half of respondents reported providing written action plans to less than 20% of their asthma patients, although allergists reported providing action plans to a significantly higher percentage than other physicians. Pulmonologists and allergists also reported providing instructions on proper inhaler device use to substantially more patients than other physicians.CONCLUSIONS: Awareness and adoption of the NAEPP’s key clinical recommendations is suboptimal. Pulmonologists, allergists, and pediatricians report significantly greater awareness and adoption of these recommendations.

CLINICAL IMPLICATIONS:  Tailored educational efforts and process improvements are needed to achieve the goal of increased physician compliance with the NAEPP recommendations for high-quality asthma care.

DISCLOSURE:  R.A. Feifer, Schering-Plough, Grant monies.

Tuesday, October 28, 2003

10:30 AM - 12:00 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Current and future management of the young child with early onset wheezing. Curr Opin Allergy Clin Immunol Published online Jan 13, 2017;
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543