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Pediatr Pulmonol. 2012 May;47(5):434-40. doi: 10.1002/ppul.21573. Epub 2012 Jan 3.

Adherence to the 2007 cystic fibrosis pulmonary guidelines: a national survey of CF care centers.

Author information

  • 1CE Outcomes, LLC, Birmingham, Alabama, USA. terry.glauser@ceoutcomes.com

Abstract

OBJECTIVE:

To examine cystic fibrosis (CF) physician adherence to the 2007 CF Foundation (CFF) Pulmonary Guidelines for Chronic Medications. Specifically adherence and barriers to prescribing level A medication recommendations (i.e., inhaled tobramycin and dornase alfa) and level B medication recommendations (i.e., macrolide antibiotics and hypertonic saline) were studied.

METHODS:

During Spring 2010, the CFF emailed survey invitations to directors of 136 accredited CF care centers treating 50+ CF patients. Directors were asked to forward the invitations to their physician colleagues. One hundred thirty-three surveys were included in the analyses, representing 92 centers. Barriers were conceptualized based on Cabana et al.'s framework for adherence to guidelines. Adherence was assessed via a case vignette.

RESULTS:

Logistic regression analysis revealed that higher outcome expectancy (OR = 1.099, CI 1.010-1.196) and fewer environmental/system barriers (OR = 1.484, CI 1.158-1.902) were significantly associated with Vignette Adherence. A trend for an association between Familiarity and Vignette Adherence (OR = 1.642, CI 0.953-2.828) was evident, while no demographic variables were significantly associated with Vignette Adherence.

CONCLUSION:

Targeting outcome expectancy and external barriers with multifaceted, ongoing interventions may improve guideline adherence. Pulmonologists are clearly looking for empirical evidence that these medications benefit their patients over the long-term and offset patient treatment burden with improved health.

Copyright © 2012 Wiley Periodicals, Inc.

PMID:
22495970
[PubMed - indexed for MEDLINE]
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