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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
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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


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