Related Experiment Video
Updated: Mar 16, 2026
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
A randomized trial of pocket cards to increase implementation of the 2020 NHLBI asthma guidelines
Alan P Baptist1, Jenny J Lee2, Gita Sabhapathy3
1Division of Allergy & Clinical Immunology, Henry Ford Health, Detroit, MI, USA.
Insights
Pocket cards, electronic or print, improved primary care providers' knowledge of asthma guidelines. While useful, remembering to use them during patient visits remains a challenge for effective implementation.
Area of Science:
- Pulmonology
- Medical Education
- Primary Care
Background:
- The National Heart, Lung, and Blood Institute (NHLBI) released Focused Asthma Management Updates in 2020.
- Awareness, knowledge, and implementation of these crucial asthma guidelines among healthcare providers have been insufficient.
- Effective strategies are needed to improve adherence to updated asthma management protocols.
Purpose of the Study:
- To evaluate the effectiveness of electronic and print pocket cards in enhancing the implementation of NHLBI 2020 Asthma Guideline Updates among primary care providers (PCPs).
- To assess the impact of pocket cards on PCPs' knowledge and perceived usefulness regarding asthma management.
- To identify barriers to the consistent use of these educational tools in clinical practice.
Main Methods:
- A prospective, randomized trial involving 138 PCPs who received either an electronic or print version of an asthma management pocket card.
- Knowledge-based surveys administered at baseline and after one month of pocket card use.
- Follow-up assessment included questions on pocket card utilization, settings of use, and perceived effectiveness.
Main Results:
- Participant knowledge scores significantly improved in both electronic (46.9% to 56.7%) and print (42.2% to 57.3%) pocket card groups (p < 0.001).
- No significant difference in knowledge improvement was observed between the electronic and print formats.
- A high percentage found the cards useful (71.4% electronic, 83.3% print), but only 50% consistently remembered to use them during clinical encounters.
Conclusions:
- Both electronic and print pocket cards serve as effective tools for increasing medical knowledge related to the Focused Asthma Updates.
- These pocket cards can be a valuable component of strategies aimed at improving the implementation of asthma guidelines.
- Further strategies may be needed to address the challenge of consistent utilization during patient care to maximize guideline implementation.
Objective:
In 2020, the NHLBI released the Focused Asthma Management Updates. However, awareness, knowledge, and implementation of these guidelines have been inadequate. Here, we evaluate the ability of electronic and print versions of a pocket card containing key recommendations from the NHLBI 2020 Asthma Guideline Update to increase implementation among primary care providers (PCPs).
Methods:
In a prospective, randomized trial, 138 PCPs were given an electronic or print version of a pocket card with information on asthma treatment and management. A knowledge-based survey was provided at baseline, and after 1 month of use of the pocket card, the survey was repeated. Implementation questions at the 1-month follow-up included utilization of the pocket cards, settings in which they were used, and perceived usefulness.
Results:
77 participants (55.8%) completed both baseline and follow-up surveys. At baseline, the mean percent-correct score for the electronic pocket card group was 46.9% and the print-out pocket card group was 42.2%. After the intervention, the scores for both groups improved to 56.7% and 57.3% respectively (p < 0.001 for both groups compared to baseline). There was no significant difference between groups. 71.4% of the electronic and 83.3% of the printed pocket card groups reported that the pocket cards were at least somewhat effective/useful, but only 50% of each group remembered to use the card during clinical encounters.
Conclusions:
Both electronic and printed pocket cards can increase medical knowledge around the Focused Asthma Updates and may be considered as part of an implementation strategy.
Related Concept Videos
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:29Asthma-I: Introduction
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management