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Impact of consensus development conference guidelines on primary care of bronchiolitis: are national guidelines being

Sandrine Touzet1, Luc Réfabert, Laurent Letrilliart

  • 1Department of Medical Information, Hospices Civils de Lyon, Claude Bernard University Lyon I, France. sandrine.touzet@chu-lyon.fr

Journal of Evaluation in Clinical Practice
|August 9, 2007
PubMed

Insights

French national guidelines for bronchiolitis management showed slight improvements in primary care practices. Adherence to general advice increased significantly, but other areas like hospitalization and antibiotic prescribing saw no significant change.

Area of Science:

  • Pediatrics
  • Public Health
  • Clinical Practice Guidelines

Background:

  • Bronchiolitis is a common respiratory infection in infants.
  • Clinical practice guidelines aim to standardize and improve bronchiolitis management.
  • The impact of national guidelines on primary care practices requires evaluation.

Purpose of the Study:

  • To assess the effect of French national consensus guidelines on the clinical practices of primary care pediatricians and general practitioners.
  • To evaluate changes in the management of infants with bronchiolitis following guideline implementation.

Main Methods:

  • A non-randomized intervention study design was employed.
  • Two surveys were conducted: one year before and one year after guideline dissemination via medical press and internet.
  • Paediatricians and general practitioners treating infants under one year with first-time bronchiolitis episodes were included.

Main Results:

  • Adherence to guidelines for general advice saw the largest increase (29.0% to 57.1%).
  • Adherence to flow modulation respiratory physical therapy also increased significantly (91.9% to 98.8%).
  • No statistically significant changes were observed in adherence for hospitalization, antibiotic prescribing, or complementary examinations.

Conclusions:

  • National consensus guidelines led to modest improvements in primary care bronchiolitis management.
  • Non-validated drug use remains prevalent, indicating a need for further intervention.
  • Enhanced resources are necessary to improve primary care physicians' adherence to guidelines.
Abstract

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