Environmental Management of Asthma in Clinical Practice: Results from the 2012 National Ambulatory Medical Care Survey

Details

• Personal Author:
  Akinbami LJ ; Cloutier MM ; Diette GB ; Elward KS ; Mazurek JM ; Mitchell TA ; Salo PM ; Wilkerson JC ; Williams S ; Zeldin DC
• Description:
  Background: The National Asthma Education and Prevention Program guidelines emphasize environmental control as an integral part of asthma management; however, limited national-level data exist on how clinicians implement environmental control recommendations. Objective: We analyzed data on clinicians' self-reported use of recommended environmental control practices in a nationally representative sample (n = 1645) of primary care physicians, asthma specialists, and advanced practice providers from the National Asthma Survey of Physicians, a supplemental questionnaire to the 2012 National Ambulatory Medical Care Survey. Methods: We examined clinician and practice characteristics as well as clinicians' decisions and strategies regarding environmental trigger assessment and environmental control across provider groups. Regression modeling was used to identify clinician and practice characteristics associated with implementation of guideline recommendations. Results: A higher percentage of specialists assessed asthma triggers at home, school, and/or work than primary care or advanced practice providers (almost always: 53.6% vs 29.4% and 23.7%, respectively, P < .001). Almost all clinicians (>93%) recommended avoidance of secondhand tobacco smoke, whereas recommendations regarding cooking appliances (eg, proper ventilation) were infrequent. Although assessment and recommendation practices differed between clinician groups, modeling results showed that clinicians who reported almost always assessing asthma control were 5- to 6-fold more likely to assess environmental asthma triggers. Use of asthma action plans was also strongly associated with implementation of environmental control recommendations. Conclusions: Environmental assessment and recommendations to patients varied among asthma care providers. High adherence to other key guideline components, such as assessing asthma control, was associated with environmental assessment and recommendation practices on environmental control. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Health Personnel Occupational Health Safety Surveys And Questionnaires
• Keywords:
  Asthma Guidelines Author Keywords: Asthma Environmental Control Guideline Implementation National Survey Physicians Questionnaires
• ISSN:
  2772-8293
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Connecticut ; District of Columbia ; Maryland ; North Carolina ; OSHA Region 1 ; OSHA Region 3 ; OSHA Region 4 ; Virginia ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  3
• Issue:
  1
• NIOSHTIC Number:
  nn:20069070
• Citation:
  J Allergy Clin Immunol Glob 2024 Feb; 3(1):100192
• Contact Point Address:
  Darryl C. Zeldin, MD, NIEHS/NIH, 111 T. W. Alexander Dr, Rm A214, Research Triangle Park, NC 27709
• Email:
  zeldin@niehs.nih.gov
• Federal Fiscal Year:
  2024
• Peer Reviewed:
  True
• Source Full Name:
  Journal of Allergy and Clinical Immunology: Global
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:240577424ae3ec7613508beddd19e1cd501fe86a040444d48c412bcabbf0ba4dfb763674501dba7be42db97ca1d5d07bc889a0c80cbbbd633951d2b4b38879d5
• Download URL:
  https://stacks.cdc.gov/view/cdc/207617/cdc_207617_DS1.pdf
• File Type:
  [PDF - 2.08 MB ]