Abstract：
BACKGROUND: Primary care clinicians do not adhere to national and international guidelines recommending pulmonary function testing (PFTs) in patients with suspected asthma. Little is known about why that occurs. Our objective was to assess clinician focused barriers to ordering PFTs.
METHODS: An internet-based 11-item survey of primary care clinicians at a large safety-net institution was conducted between August 2021 and November 2021. This survey assessed barriers and possible electronic health record (EHR) solutions to ordering PFTs. One of the survey questions contained an open-ended question about barriers which was analyzed qualitatively.
RESULTS: The survey response rate was 59% (117/200). The top 3 reported barriers included beliefs that testing will not change management, distance to testing site, and the physical effort it takes to complete testing. Clinicians were in favor of an EHR intervention to prompt them to order PFTs. Responses to the open-ended question also conveyed that objective testing does not change management.
CONCLUSIONS: PFTs improve diagnostic accuracy and reduce inappropriate therapies. Of the barriers we identified, the most modifiable is to educate clinicians about how PFTs can change management. That in conjunction with an EHR prompt, which clinicians approved of, may lead to guideline congruent and improved quality in asthma care.
METHODS: An internet-based 11-item survey of primary care clinicians at a large safety-net institution was conducted between August 2021 and November 2021. This survey assessed barriers and possible electronic health record (EHR) solutions to ordering PFTs. One of the survey questions contained an open-ended question about barriers which was analyzed qualitatively.
RESULTS: The survey response rate was 59% (117/200). The top 3 reported barriers included beliefs that testing will not change management, distance to testing site, and the physical effort it takes to complete testing. Clinicians were in favor of an EHR intervention to prompt them to order PFTs. Responses to the open-ended question also conveyed that objective testing does not change management.
CONCLUSIONS: PFTs improve diagnostic accuracy and reduce inappropriate therapies. Of the barriers we identified, the most modifiable is to educate clinicians about how PFTs can change management. That in conjunction with an EHR prompt, which clinicians approved of, may lead to guideline congruent and improved quality in asthma care.
摘要：
背景：初级保健临床医生不遵守推荐对疑似哮喘患者进行肺功能检测（PFTs）的国家和国际指南。人们对为什么会发生这种情况知之甚少。我们的目标是评估临床医生关注订购PFTs的障碍。
方法：在2021年8月至2021年11月期间，对一家大型安全网机构的初级保健临床医生进行了一项基于互联网的11项调查。这项调查评估了订购PFT的障碍和可能的电子健康记录（EHR）解决方案。其中一个调查问题包含一个关于障碍的开放式问题，并进行了定性分析。
结果：调查应答率为59%（117/200）。报告的前三个障碍包括相信测试不会改变管理，到测试地点的距离，以及完成测试所需的体力。临床医生赞成EHR干预，以促使他们订购PFT。对开放式问题的回应还表明，客观测试不会改变管理。
结论：PFTs提高了诊断准确性并减少了不适当的治疗。在我们发现的障碍中，最可修改的是教育临床医生关于PFTs如何改变管理.结合EHR提示，临床医生批准的，可能导致哮喘治疗的指南一致和质量改善。
方法：在2021年8月至2021年11月期间，对一家大型安全网机构的初级保健临床医生进行了一项基于互联网的11项调查。这项调查评估了订购PFT的障碍和可能的电子健康记录（EHR）解决方案。其中一个调查问题包含一个关于障碍的开放式问题，并进行了定性分析。
结果：调查应答率为59%（117/200）。报告的前三个障碍包括相信测试不会改变管理，到测试地点的距离，以及完成测试所需的体力。临床医生赞成EHR干预，以促使他们订购PFT。对开放式问题的回应还表明，客观测试不会改变管理。
结论：PFTs提高了诊断准确性并减少了不适当的治疗。在我们发现的障碍中，最可修改的是教育临床医生关于PFTs如何改变管理.结合EHR提示，临床医生批准的，可能导致哮喘治疗的指南一致和质量改善。
