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Providers' Adherence to Evidence-Based Asthma Guidelines in Pediatric Primary Care

Published:November 16, 2020DOI:https://doi.org/10.1016/j.pedn.2020.09.020

      Abstract

      Background

      Regardless of existence of National asthma guidelines, adherence to major elements of guidelines among providers is suboptimal. The nonadherence contributes to poor clinical outcomes and quality of life of asthma patients.

      Purpose

      This project aims to improve the standard of care of asthma patients with increased providers' adherence to asthma guidelines through provider education, and implementation of practice guidelines and evidence-based resources.

      Methods

      A pre-post implementation retrospective design was adopted along with the provision of provider education sessions and implementation of pediatric asthma management practice guidelines and asthma resources in the pediatric practice in Southern, New Jersey. Data were collected via retrospective chart review among 41 patients four-months pre-implementation and 38 patients three months post-implementation to assess the improvement of providers' adherence to seven elements of asthma guidelines. Descriptive statistics and chi-square tests were computed to evaluate providers' adherence.

      Results

      Results showed improvement from pre- to post-implementation in utilization of six of the seven key elements of guidelines among providers that include, the assessment and documentation of asthma control (4.9% to 39.5%), medication adherence (20% to 87.5%), medication delivery technique (7.3% to 18.4%), environmental triggers (14.6% to 44.7%), asthma action plan (4.9% to 28.9%), and follow-up visits (48.8% to 76.3%). In addition, the chi-square test showed a significant association between environmental triggers assessment from baseline to post-implementation, χ2 (1, n = 79) = 4.29, p = .038.

      Conclusion

      Providing necessary resources and provider-focused education demonstrated a positive change in promoting best practice and facilitating providers' adherence.

      Keywords

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