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J Am Board Fam Med. 2014 May-Jun;27(3):391-8. doi: 10.3122/jabfm.2014.03.130241.

Improving quality of care and guideline adherence for asthma through a group self-assessment module.

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1
Family Medicine of Albemarle, Charlottesville, VA; Department of Family Medicine and Population Health, the Virginia Commonwealth University, Richmond; The American Board of Family Medicine, Lexington, KY; the Department of Family and Community Medicine, University of Kentucky College of Medicine, Lexington; and the Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine and Research Institute, Roanoke.

Abstract

BACKGROUND:

The quality of care for asthma remains suboptimal. Compliance with guidelines remains low, but improved adherence to guidelines may increase the quality of care. but. We conducted a trial to determine whether group Self-Assessment Module (SAM) activities led by a facilitator and conducted as part of Maintenance of Certification for Family Physicians (MC-FP) would increase knowledge of and adherence to asthma guidelines.

METHODS:

Participating physicians completed audits of the charts of patients with asthma before and 6 months after a group SAM. Surveys of physicians' knowledge of asthma guidelines were administered immediately before, immediately after, and 6 months after the group SAM. We tested for differences in knowledge of and adherence to guidelines before and after the SAM using χ(2) and t tests.

RESULTS:

Thirty-eight physicians in Virginia completed the SAM and had complete data. Participants completed more MC-FP activities than other physicians but were comparable in other characteristics. Except for prescribing controller medications for persistent asthma, all other quality measures significantly improved 6 months after the group SAM. Diagnosis by severity improved from 48.3% to 80.2%, and the use of action plans increased from 8.1% to 54.1%. Physicians' knowledge of guidelines improved immediately after the SAM and was sustained at 6 months. Increased knowledge translated into clinical skills: 30% of participants reported comfort with assessing control after the SAM, which increased to 97.5% 6 months after the SAM.

CONCLUSIONS:

Group SAMs may be an effective method to increase physicians' knowledge of and adherence to clinical guidelines.

KEYWORDS:

Asthma; Certification; Educational Assessment; Guideline Adherence

PMID:
24808118
DOI:
10.3122/jabfm.2014.03.130241
[Indexed for MEDLINE]
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