Use of National Asthma Guidelines by Allergists and Pulmonologists: A National Survey

Details

• Personal Author:
  Akinbami LJ ; Cloutier MM ; Diette G ; Elward KS ; Feinstein L ; Fuhlbrigge A ; Mazurek JM ; Salo PM ; Schatz M ; Simoneau T ; Wilkerson JC ; Williams S ; Zeldin DC
• Description:
  Background: Little is known about specialist-specific variations in guideline agreement and adoption. Objective: To assess similarities and differences between allergists and pulmonologists in adherence to cornerstone components of the National Asthma Education and Prevention Program's Third Expert Panel Report. Methods: Self-reported guideline agreement, self-efficacy, and adherence were assessed in allergists (n = 134) and pulmonologists (n = 99) in the 2012 National Asthma Survey of Physicians. Multivariate models were used to assess if physician and practice characteristics explained bivariate associations between specialty and "almost always" adhering to recommendations (ie, >=75% of the time). Results: Allergists and pulmonologists reported high guideline self-efficacy and moderate guideline agreement. Both groups "almost always" assessed asthma control (66.2%, standard error [SE] 4.3), assessed school/work asthma triggers (71.3%, SE, 3.9), and endorsed inhaled corticosteroids use (95.5%, SE 2.0). Repeated assessment of the inhaler technique, use of asthma action/treatment plans, and spirometry were lower (39.7%, SE 4.0; 30.6%, SE 3.6; 44.7%, SE 4.1, respectively). Compared with pulmonologists, more allergists almost always performed spirometry (56.6% vs 38.6%, P = .06), asked about nighttime awakening (91.9% vs 76.5%, P = .03) and emergency department visits (92.2% vs 76.5%, P = .03), assessed home triggers (70.5% vs 52.6%, P = .06), and performed allergy testing (61.8% vs 21.3%, P < .001). In multivariate analyses, practice-specific characteristics explained differences except for allergy testing. Conclusions: Overall, allergists and pulmonologists adhere to the asthma guidelines with notable exceptions, including asthma action plan use and inhaler technique assessment. Recommendations with low implementation offer opportunities for further exploration and could serve as targets for increasing guideline uptake. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Behavior Diagnosis Health Personnel Hypersensitivity Lung Occupational Health Respiratory Function Tests Respiratory System Safety

  More +
• Keywords:
  Administration Agreement Allergies Asthma Treatment Plan Author Keywords: Self-efficacy Clinical Symptoms Compliance Diagnostic Tests Guidelines Health Care Inhaler Technique Medical Management Guidelines Medical Personnel Medical Screening Medical Surveys Medical Treatment Models NAEPP Physicians Pulmonary System Recommendations Spirometry Statistical Analysis Surveillance Work Operations Work Practices

  More +
• ISSN:
  2213-2198
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  California ; Colorado ; Connecticut ; Maryland ; Massachusetts ; North Carolina ; OSHA Region 1 ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 8 ; OSHA Region 9 ; 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:
  8
• Issue:
  9
• NIOSHTIC Number:
  nn:20059675
• Citation:
  J Allergy Clin Immunol Pract 2020 Oct; 8(9):3011-3020.e2
• Contact Point Address:
  Lara J. Akinbami, MD, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Room 3418, Hyattsville, MD 20782
• Email:
  lea8@cdc.gov
• Federal Fiscal Year:
  2021
• Peer Reviewed:
  True
• Source Full Name:
  Journal of Allergy and Clinical Immunology: In Practice
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:6e8542b40a6eb16c648962d618bb9967b462d9192f1ef24d48c97ee2e5f6fb2bfcec1b032ac525f81a1039f5b1959fc00280b2ba208cf29b920a26ed4b3af279
• Download URL:
  https://stacks.cdc.gov/view/cdc/223824/cdc_223824_DS1.pdf
• File Type:
  [PDF - 264.24 KB ]