Grant E N, Moy J N, Turner-Roan K, Daugherty S R, Weiss K B
Department of Immunology/Microbiology, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL 60612, USA.
Chest. 1999 Oct;116(4 Suppl 1):145S-154S. doi: 10.1378/chest.116.suppl_2.145s.
Although primary-care physicians were a principal target audience for the National Asthma Education and Prevention Program (NAEPP), there is little published information describing the postguideline asthma care practices of these physicians or their willingness to embrace the NAEPP guidelines. This study examines asthma care practices of Chicago-area primary-care physicians and assesses these practitioners' perceptions and beliefs about several aspects of the NAEPP guidelines.
In 1997, a self-administered survey was mailed to a randomly selected 10% sample of Chicago-area general pediatricians, internists, and family practitioners.
Surveys were returned by 244 of the 405 eligible Chicago-area primary-care physicians (60.2%) in the sample. Of these, 66 (27.6%) were pediatricians, 83 (34.7%) were general internists, and 90 (37.7%) were family practitioners. Physicians reported that 54.6 +/- 2.7% (mean +/- SE) of patients with newly diagnosed asthma have spirometry performed as part of their initial evaluation. For patients with moderate persistent asthma, prescribing of inhaled corticosteroids varied by patient age, with 60.5% of physicians routinely prescribing them for patients < 5 years, compared with 95.7% of physicians prescribing them for patients > or = 5 years. Awareness of the NAEPP guide-lines among these physicians was high, with 88.5% reporting that they have heard of the guidelines, and 73.6% reporting having read them. Of patients with moderate or severe persistent asthma, physicians estimated that 47.7 +/- 2.7% were given written treatment plans.
Several aspects of the NAEPP guidelines appear to have been incorporated into clinical practice by Chicago-area primary-care physicians, whereas other recommendations do not appear to have been readily adopted. This information suggests areas for interventions to improve primary care for asthma in the Chicago area.
尽管基层医疗医生是国家哮喘教育与预防计划（NAEPP）的主要目标受众，但关于这些医生在指南发布后的哮喘护理实践或他们接受NAEPP指南的意愿的公开信息很少。本研究调查了芝加哥地区基层医疗医生的哮喘护理实践，并评估了这些从业者对NAEPP指南几个方面的看法和信念。
1997年，向芝加哥地区随机抽取的10%的普通儿科医生、内科医生和家庭医生邮寄了一份自填式调查问卷。
样本中的405名符合条件的芝加哥地区基层医疗医生中有244名（60.2%）回复了调查问卷。其中，66名（27.6%）是儿科医生，83名（34.7%）是普通内科医生，90名（37.7%）是家庭医生。医生报告说，54.6±2.7%（平均值±标准误）新诊断哮喘患者在初始评估时进行了肺功能测定。对于中度持续性哮喘患者，吸入性糖皮质激素的处方因患者年龄而异，60.5%的医生常规为<5岁的患者开此类药物，而95.7%的医生为≥5岁的患者开此类药物。这些医生对NAEPP指南的知晓率很高，88.5%的医生报告说他们听说过该指南，73.6%的医生报告说读过该指南。对于中度或重度持续性哮喘患者，医生估计有47.7±2.7%的患者得到了书面治疗计划。
NAEPP指南的几个方面似乎已被芝加哥地区基层医疗医生纳入临床实践，而其他建议似乎未被轻易采用。这些信息提示了在芝加哥地区改善哮喘初级护理的干预领域。
