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A pilot study to improve provider adherence to NAEPP guidelines

Joanne M Fierro1, Mary Ann Lewis1, Mary-Lynn Brecht1

  • 1University of California, Los Angeles, United States of America.

Journal of Pediatric Nursing
|July 27, 2023
PubMed

Insights

Integrating an asthma registry into electronic medical records improved provider adherence to National Asthma Education and Prevention Program (NAEPP) guidelines. This intervention enhanced patient care and outcomes by increasing the use of asthma control tests, action plans, and medications.

Area of Science:

  • Pulmonary Medicine
  • Health Informatics
  • Health Services Research

Background:

  • Asthma prevalence and morbidity have risen in the US, despite published guidelines.
  • Provider adherence to the National Asthma Education and Prevention Program (NAEPP) Expert Panel Report-3 (EPR-3) guidelines remains a challenge.

Purpose of the Study:

  • To evaluate the effectiveness of integrating the Pediatric Asthma Registry (PAR) into the electronic medical record (EMR) to improve provider adherence to NAEPP guidelines.
  • To assess the impact of this intervention on asthma management practices.

Main Methods:

  • A serial cross-sectional study compared provider management of asthma patients before (2014) and after (2018) EMR integration of the PAR.
  • Four adherence measures were evaluated: Asthma Control Test (ACT), Asthma Action Plan (AAP), inhaled corticosteroids (ICS), and spacers.
  • Statistical analyses included General Linear Mixed Models and Chi square tests.

Main Results:

  • In 2018, patients were significantly more likely to receive an ACT (OR=14.95), AAP (OR=12.70), ICS (OR=1.85), and spacer (OR=1.45) compared to 2014.
  • These findings indicate a substantial increase in guideline-adherent care post-intervention.

Conclusions:

  • EMR integration of the Pediatric Asthma Registry serves as an effective clinical decision support tool.
  • The intervention successfully increased provider adherence to NAEPP asthma guidelines.
  • Sustained improvement requires ongoing monitoring, education, and potentially multi-site research.

Keywords:
AdherenceAsthmaChildrenElectronic medical recordGuidelinesPediatricProvidersRegistry

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