A short-term educational program improved physicians’ adherence to guidelines for COPD and asthma in Shanghai

Fang Xiaocong, Li Shanqun, Gao Lei, Zhao Naiqing, Wang Xiangdong, Bai, Bai Chunxue

Description

Chronic pulmonary diseases such as chronic obstructive pulmonary disease (COPD) and asthma exert increasing burden on society while the management of them is far from adequate. The objective of this study is to evaluate adherence to guidelines through a patient study, and then investigate the effects of a short-term quality improvement educational program among clinicians in Shanghai, China. Methods A prescription survey was performed in a random sample of 100 COPD and asthma outpatients to assess their pharmacological therapy. Then, an educational program was conducted in young pulmonary physicians from 83 hospitals in Shanghai. The training course was divided into 7 sessions of 2 hours delivered over 4 days from July 2010 to August 2011. Three months later, all of the participants were asked to take a written examination to assess the efficiency of training. Results Prescription survey among the patients indicated the prescriptions are not consistent with the recommendations of current GOLD and GINA guidelines. The mainly existing issue is the overuse of inhaled glucocorticosteroid. For the educational program, 161 pulmonary physicians have attended the training course, and 110 clinicians finished the tests with an attendance rate of 68.3%. Although most of the clinicians recognized the increasing burden of COPD and asthma, they do not know well about the core elements of guidelines and their clinical practice is not fully in agreement with current recommendations. Through crossover comparison, our results suggested clinicians’ knowledge of the guidelines was improved after training. Conclusions We concluded that application of continuous educational programs among physicians might promote their adherence to guidelines, and by that improve the quality of healthcare.

Sujets

• Chronic obstructive pulmonary disease
• Asthma
• Clinic
• Quality management

Informations

• Publié par: biomed
• Publié le: 01 janvier 2012
• Nombre de lectures: 8
• Langue: English

Extrait

Fanget al. Clinical and Translational Medicine2012,1:13 http://www.clintransmed.com/content/1/1/13

R E S E A R C HOpen Access A shortterm educational program improved physicians’adherence to guidelines for COPD and asthma in Shanghai 1 11 21,3* 1* Xiaocong Fang , Shanqun Li , Lei Gao , Naiqing Zhao , Xiangdong Wangand Chunxue Bai

Abstract Background:Chronic pulmonary diseases such as chronic obstructive pulmonary disease (COPD) and asthma exert increasing burden on society while the management of them is far from adequate. The objective of this study is to evaluate adherence to guidelines through a patient study, and then investigate the effects of a shortterm quality improvement educational program among clinicians in Shanghai, China. Methods:A prescription survey was performed in a random sample of 100 COPD and asthma outpatients to assess their pharmacological therapy. Then, an educational program was conducted in young pulmonary physicians from 83 hospitals in Shanghai. The training course was divided into 7 sessions of 2 hours delivered over 4 days from July 2010 to August 2011. Three months later, all of the participants were asked to take a written examination to assess the efficiency of training. Results:Prescription survey among the patients indicated the prescriptions are not consistent with the recommendations of current GOLD and GINA guidelines. The mainly existing issue is the overuse of inhaled glucocorticosteroid. For the educational program, 161 pulmonary physicians have attended the training course, and 110 clinicians finished the tests with an attendance rate of 68.3%. Although most of the clinicians recognized the increasing burden of COPD and asthma, they do not know well about the core elements of guidelines and their clinical practice is not fully in agreement with current recommendations. Through crossover comparison, our results suggested clinicians’knowledge of the guidelines was improved after training. Conclusions:We concluded that application of continuous educational programs among physicians might promote their adherence to guidelines, and by that improve the quality of healthcare. Keywords:Chronic obstructive pulmonary disease, Asthma, Clinicians, Quality improvement

Background Chronic obstructive pulmonary disease (COPD) and asthma are both chronic respiratory diseases character ized by the impairment of lung function, and they are also complex multicomponent diseases accompanied with mental and physical comorbidities [1,2]. In recent years, there has been increasing evidences suggesting that COPD and asthma are imposing enormous burden on patients, healthcare professionals and society in terms

* Correspondence: [e-mail]; bai.chunxue@zshospital.sh.cn 1 Department of Pulmonary Medicine, Research Institute of Respiratory Disease, Fudan University, Zhongshan Hospital, Shanghai 200032, PR China 3 Biomedical Research Center, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China Full list of author information is available at the end of the article

of morbidity, mortality, healthcare resources utilization and expense worldwide [3], especially in developing countries [49]. Despite these striking statistics, the management of COPD and asthma is far from adequate. One major bar rier to better patient outcomes is underdiagnosis and undertreatment of the diseases. It was reported that only 1/3 of the patients were diagnosed early and that less than onethird of COPD diagnoses were supported by spirometry in China [9]. Give COPD and asthma are preventable and treatable diseases, clinical practice guidelines are systematically developed to improve the quality of care by providing information and sound clin ical recommendations to clinicians [10]. Since the late 1980s, many international and national COPD and

© 2012 Fang et al.; licensee Springer. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.