Asthma Survey of Physicians

Details

• Alternative Title:
  J Asthma
• Personal Author:
  Akinbami, Lara J. ; Salo, Paivi M. ; Cloutier, Michelle M. ; Wilkerson, Jesse C. ; Elward, Kurtis S. ; Mazurek, Jacek M. ; Williams, Sonja ; Zeldin, Darryl C.
• 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:
  Article
• 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):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e8070d6cda8c90ad4cdda2ef0e642cf61fbf296191406aa1e968977710d5a3ba
• Download URL:
  https://stacks.cdc.gov/view/cdc/81108/cdc_81108_DS1.pdf
• File Type:
  [PDF - 676.71 KB ]