Improving family practice residents' compliance with asthma practice guidelines

This study primarily determined the effect of an educational and system intervention on residents' documentation of the severity classification of asthma. Secondarily, the study assessed the effect of classification on pharmacologic treatment, as outlined by national asthma treatment guidelines.

We reviewed the charts of all patients with asthma seen by the residents in the Center for Family Medicine (CFM) between October 1, 1998, and March 31, 1999. Data gathered from each chart included, but was not limited to, disease severity classification and medication regimen. Between July 1999 and October 1999, efforts at increasing residents' knowledge of asthma severity classification were made via formal and informal teaching. A post-intervention chart review was performed on all patients with asthma seen by the residents in the CFM between October 1, 1999, and March 31, 2000.

A total of 8.5% of 198 and 51% of 271 patient visits were classified with respect to asthma severity in the pre- and post-intervention periods, respectively. Classified patients were treated appropriately 100% of the time in the pre-intervention period and 76% of the time in the post-intervention period.

A comprehensive protocol significantly improved compliance with national asthma treatment guidelines with respect to severity classification but not pharmacologic treatment.