Asthma Survey of Physicians
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Asthma Survey of Physicians

Filetype[PDF-676.71 KB]


English
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Details:

  • Alternative Title:
    J Asthma
  • Personal Author:
  • Description:
    Background and Objectives:

    Although primary care clinicians provide >60% of U.S. asthma care, no nationally representative study has examined variation in adherence among primary care groups to four cornerstone domains of the Expert Panel Report-3 asthma guidelines: assessment/monitoring, patient education, environmental assessment, and medications. We used the 2012 National Asthma Survey of Physicians: National Ambulatory Medical Care Survey to compare adherence by family/general medicine practitioners (FM/GM), internists, pediatricians and Community Health Center mid-level clinicians (CHC).

    Methods:

    Adherence was self-reported (n=1,355 clinicians). Adjusted odds of almost always adhering to each recommendation (≥75% of the time) were estimated controlling for clinician/practice characteristics, and agreement and self-efficacy with guideline recommendations.

    Results:

    A higher percentage of pediatricians adhered to most assessment/monitoring recommendations compared to FM/GM and other groups (e.g., 71.6% [SE 4.0] almost always assessed daytime symptoms versus 50.6% [SE 5.1]-51.1% [SE 5.8], t-test P<.05) but low percentages from all groups almost always performed spirometry (6.8% [SE 2.0]-16.8% [SE 4.7]). Pediatricians were more likely to provide asthma action/treatment plans than FM/GM and internists. Internists were more likely to assess school/work triggers than pediatricians and CHC (environmental assessment). All groups prescribed inhaled corticosteroids for daily control (84.0% [SE 3.7]-90.7% [SE 2.5]) (medications). In adjusted analyses, pediatric specialty, high self-efficacy and frequent specialist referral were associated with high adherence.

    Conclusions:

    Pediatricians were more likely to report high adherence than other clinicians. Self-efficacy and frequent referral were also associated with adherence. Adherence was higher for history-taking recommendations and lower for recommendations involving patient education, equipment and expertise.

  • Subjects:
  • Source:
    J Asthma. :1-13
  • Pubmed ID:
    30821526
  • Pubmed Central ID:
    PMC6717679
  • Document Type:
    Journal Article
  • Funding:
    CC999999/ImCDC/Intramural CDC HHS/United States
  • Collection(s):
  • Main Document Checksum:
  • Download URL:
  • File Type:

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