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Abstract：
BACKGROUND: Regardless of existence of National asthma guidelines, adherence to major elements of guidelines among providers is suboptimal. The nonadherence contributes to poor clinical outcomes and quality of life of asthma patients.
OBJECTIVE: This project aims to improve the standard of care of asthma patients with increased providers\' adherence to asthma guidelines through provider education, and implementation of practice guidelines and evidence-based resources.
METHODS: A pre-post implementation retrospective design was adopted along with the provision of provider education sessions and implementation of pediatric asthma management practice guidelines and asthma resources in the pediatric practice in Southern, New Jersey. Data were collected via retrospective chart review among 41 patients four-months pre-implementation and 38 patients three months post-implementation to assess the improvement of providers\' adherence to seven elements of asthma guidelines. Descriptive statistics and chi-square tests were computed to evaluate providers\' adherence.
RESULTS: Results showed improvement from pre- to post-implementation in utilization of six of the seven key elements of guidelines among providers that include, the assessment and documentation of asthma control (4.9% to 39.5%), medication adherence (20% to 87.5%), medication delivery technique (7.3% to 18.4%), environmental triggers (14.6% to 44.7%), asthma action plan (4.9% to 28.9%), and follow-up visits (48.8% to 76.3%). In addition, the chi-square test showed a significant association between environmental triggers assessment from baseline to post-implementation, χ2 (1, n = 79) = 4.29, p = .038.
CONCLUSIONS: Providing necessary resources and provider-focused education demonstrated a positive change in promoting best practice and facilitating providers\' adherence.
OBJECTIVE: This project aims to improve the standard of care of asthma patients with increased providers\' adherence to asthma guidelines through provider education, and implementation of practice guidelines and evidence-based resources.
METHODS: A pre-post implementation retrospective design was adopted along with the provision of provider education sessions and implementation of pediatric asthma management practice guidelines and asthma resources in the pediatric practice in Southern, New Jersey. Data were collected via retrospective chart review among 41 patients four-months pre-implementation and 38 patients three months post-implementation to assess the improvement of providers\' adherence to seven elements of asthma guidelines. Descriptive statistics and chi-square tests were computed to evaluate providers\' adherence.
RESULTS: Results showed improvement from pre- to post-implementation in utilization of six of the seven key elements of guidelines among providers that include, the assessment and documentation of asthma control (4.9% to 39.5%), medication adherence (20% to 87.5%), medication delivery technique (7.3% to 18.4%), environmental triggers (14.6% to 44.7%), asthma action plan (4.9% to 28.9%), and follow-up visits (48.8% to 76.3%). In addition, the chi-square test showed a significant association between environmental triggers assessment from baseline to post-implementation, χ2 (1, n = 79) = 4.29, p = .038.
CONCLUSIONS: Providing necessary resources and provider-focused education demonstrated a positive change in promoting best practice and facilitating providers\' adherence.
摘要：
背景：无论是否存在国家哮喘指南，提供者对准则主要要素的遵守是次优的。不依从性导致哮喘患者的临床结局和生活质量差。
目的：该项目旨在提高哮喘患者的护理标准，并通过提供者教育提高提供者对哮喘指南的依从性，以及实施实践指南和循证资源。
方法：采用了实施前回顾性设计，同时提供了提供者教育课程，并在南方儿科实践中实施了小儿哮喘管理实践指南和哮喘资源，新泽西.通过回顾性分析收集41名患者实施前4个月和实施后3个月的38名患者的数据，以评估提供者对哮喘指南7个要素的依从性的改善情况。计算描述性统计和卡方检验以评估提供者的依从性。
结果：结果显示，从实施前到实施后，提供商在使用指南的七个关键要素中的六个方面有所改善，包括：哮喘控制的评估和记录（4.9％至39.5％），药物依从性（20%至87.5%），药物输送技术(7.3%至18.4%)，环境触发因素(14.6%至44.7%)，哮喘行动计划（4.9％至28.9％），和随访(48.8%至76.3%)。此外,卡方检验显示，从基线到实施后的环境触发因素评估之间存在显著关联，χ2(1,n=79)=4.29,p=0.038。
结论：提供必要的资源和以提供者为中心的教育在促进最佳实践和促进提供者的依从性方面表现出积极的变化。
目的：该项目旨在提高哮喘患者的护理标准，并通过提供者教育提高提供者对哮喘指南的依从性，以及实施实践指南和循证资源。
方法：采用了实施前回顾性设计，同时提供了提供者教育课程，并在南方儿科实践中实施了小儿哮喘管理实践指南和哮喘资源，新泽西.通过回顾性分析收集41名患者实施前4个月和实施后3个月的38名患者的数据，以评估提供者对哮喘指南7个要素的依从性的改善情况。计算描述性统计和卡方检验以评估提供者的依从性。
结果：结果显示，从实施前到实施后，提供商在使用指南的七个关键要素中的六个方面有所改善，包括：哮喘控制的评估和记录（4.9％至39.5％），药物依从性（20%至87.5%），药物输送技术(7.3%至18.4%)，环境触发因素(14.6%至44.7%)，哮喘行动计划（4.9％至28.9％），和随访(48.8%至76.3%)。此外,卡方检验显示，从基线到实施后的环境触发因素评估之间存在显著关联，χ2(1,n=79)=4.29,p=0.038。
结论：提供必要的资源和以提供者为中心的教育在促进最佳实践和促进提供者的依从性方面表现出积极的变化。
