Impact of the national asthma guidelines on internal medicine primary care and specialty practice.

Publication/Presentation Date

10-1-2000

Abstract

OBJECTIVE: To evaluate documentation of compliance with the National Asthma Education and Prevention Program publication Guidelines for the Diagnosis and Management of Asthma.

DESIGN: A retrospective review of 114 charts coded as asthma. Fourteen chart evaluation questions were developed based on the 4 management components in the guidelines: assessment and monitoring of asthma, control of asthma factors, pharmacotherapy, and patient education.

SETTING: A hospital-based asthma clinic, a private pulmonary group, and a general internal medicine group in Dallas, Texas.

RESULTS: Nearly all physicians documented inquiries about daytime asthma symptoms, but only 64% of pulmonary group and 58% of internal medicine physicians documented inquiries about nighttime symptoms. In addition, in 14% of pulmonary group charts and 74% of internal medicine charts, no spirometry or peak flow data were documented. Most asthma clinic and pulmonary group charts (98% and 78%, respectively) included a history of triggers, but the pulmonary group and internal medicine group were more likely to document administration of the influenza vaccine than the asthma clinic (25% and 26% vs 13%). Of 38 patients with > or = 1 recorded forced expiratory volume in 1 second

CONCLUSIONS: Results showed significant variation with the recommendations. Areas in particular need of improvement were objective diagnosis and assessment, control of asthma-associated factors, and patient education. Furthermore, the study demonstrated significant variation between specialists and primary care physicians, with the more specialized clinics demonstrating better guideline compliance.

Volume

13

Issue

4

First Page

407

Last Page

412

ISSN

0899-8280

Disciplines

Medicine and Health Sciences

PubMedID

16389351

Department(s)

Patient Care Services / Nursing

Document Type

Article

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