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Providers' Adherence to Evidence-Based Asthma Guidelines in Pediatric Primary Care
1Rutgers University, School of Nursing-Camden, NJ, United States of America.
Insights
Provider education and resources significantly improved adherence to asthma guidelines, enhancing patient care. This initiative boosted the use of key asthma management elements, leading to better clinical outcomes.
Area of Science:
- Pediatric Healthcare
- Clinical Practice Guidelines
- Asthma Management
Background:
- Suboptimal adherence to national asthma guidelines by healthcare providers negatively impacts patient outcomes and quality of life.
- Improving provider adherence is crucial for enhancing the standard of care for asthma patients.
Purpose of the Study:
- To improve the standard of care for asthma patients by increasing provider adherence to asthma guidelines.
- To achieve this through targeted provider education and the implementation of evidence-based resources and practice guidelines.
Main Methods:
- A pre-post implementation retrospective study design was employed in a pediatric practice.
- Provider education sessions and practice guidelines were implemented.
- Retrospective chart reviews of 41 patients pre-implementation and 38 patients post-implementation assessed adherence to seven guideline elements.
Main Results:
- Significant improvements were observed in the utilization of six out of seven key asthma guideline elements post-implementation.
- Notable increases included asthma control documentation (4.9% to 39.5%) and medication adherence (20% to 87.5%).
- A statistically significant association was found between environmental trigger assessment and the implementation phase (p=0.038).
Conclusions:
- Provider-focused education and the provision of necessary resources positively influenced practice.
- The study demonstrated a successful strategy for promoting best practices and enhancing provider adherence to asthma guidelines.
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.
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