Enhancing Pediatric Asthma Management

加强小儿哮喘管理

基本信息

批准号：
7125156
负责人：
Michael D Cabana
金额：
$ 61.69万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2002
资助国家：
美国
起止时间：
2002-09-30 至 2009-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7125156
关键词：
asthma behavioral /social science research tag children clinical research corticosteroids health care model health care personnel performance health care service evaluation health care service utilization health services research tag human subject inhalation drug administration outcomes research patient care management patient oriented research pediatrics respiratory disorder chemotherapy

项目摘要

DESCRIPTION (provided by the applicant): The National Heart, Lung, and Blood Institute (NHLBI) Guidelines for the Diagnosis and Management of Asthma recommend that practitioners prescribe daily anti-inflammatory medications for children with persistent asthma. The guidelines specifically describe corticosteroids as "the most potent and consistently effective long-term control medication for asthma". However, despite the publication of the NHLBI guidelines, there has been limited effect on physician prescription of daily-inhaled corticosteroids (DCS) for these patients. There are limited studies evaluating methods to improve physician adherence to the NHLBI asthma guidelines. Using a randomized controlled trial design, we will evaluate the effects of barrier assessment and a multi-faceted intervention to improve pediatrician prescription of DCS to children with persistent asthma. We have developed a theoretical framework that describes barriers that physicians must overcome before adhering to a guideline. In the first phase of the proposed project, at 22 primary care pediatric practices, using this framework, we will systematically assess barriers prescribing DCS to children with persistent asthma. In the second phase of the project, we will evaluate if a multi-faceted intervention featuring interactive physician seminars, based on the barrier assessment in the first phase can promote physician prescription of DCS to pediatric patients with persistent asthma. Over a three-year period, we will measure changes in pediatrician knowledge, attitudes and practice of DCS prescription using chart audits, parent telephone survey, and physician survey. It is expected that when compared to pediatricians in the control group, pediatricians who participate in the barrier assessment and multi-faceted educational seminars will have improved knowledge and attitudes towards the use of DCS, as well as increased prescription of DCS for their patients with persistent asthma.

描述（申请人提供）：国家心脏，肺和血液研究所（NHLBI）诊断和管理哮喘的指南建议，从业者为持续性哮喘的儿童开出每日抗炎药。该指南专门将皮质类固醇描述为“哮喘最有效，最有效的长期控制药物”。然而，尽管发布了NHLBI指南，但这些患者对每日吸入的皮质类固醇（DC）的处方有限。评估方法有限的研究有限，以提高医师遵守NHLBI哮喘指南。使用随机对照试验设计，我们将评估障碍评估和多方面干预措施的影响，以改善对持续性哮喘儿童的DC的儿科处方。我们已经开发了一个理论框架，该框架描述了医师在遵守指南之前必须克服的障碍。在拟议项目的第一阶段，在22个初级保健小儿实践中，使用此框架，我们将系统地评估为持续性哮喘儿童开出DC的障碍。在项目的第二阶段中，我们将根据第一阶段的障碍评估来评估以互动医师研讨会为特色的多方面干预措施是否可以促进DC的医生处方为持续性哮喘的儿科患者。在三年内，我们将使用图表审核，家长电话调查和医师调查来衡量儿科知识，态度和实践的变化。可以预期，与对照组的儿科医生相比，参加障碍评估和多方面的教育研讨会的儿科医生将改善对使用DCS的知识和态度，并增加了DC的DC处方，以持续哮喘患者。

项目成果

期刊论文数量（13）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The unintended consequences of quality improvement.

DOI：
10.1097/mop.0b013e3283329937
发表时间：
2009-12
期刊：
Current opinion in pediatrics
影响因子：
3.6
作者：
Bardach NS;Cabana MD
通讯作者：
Cabana MD

Do School-Based Asthma Education Programs Improve Self-Management and Health Outcomes?

DOI：
10.1542/peds.2008-2085
发表时间：
2009-08-01
期刊：
PEDIATRICS
影响因子：
8
作者：
Coffman, Janet M.;Cabana, Michael D.;Yelin, Edward H.
通讯作者：
Yelin, Edward H.

At What Age Do Children Start Taking Daily Asthma Medicines on Their Own?

DOI：
10.1542/peds.2008-0292
发表时间：
2008-12-01
期刊：
PEDIATRICS
影响因子：
8
作者：
Orrell-Valente, Joan K.;Jarlsberg, Leah G.;Cabana, Michael D.
通讯作者：
Cabana, Michael D.

A randomized controlled trial to evaluate the effectiveness of a distance asthma learning program for pediatricians.

一项评估儿科医生远程哮喘学习计划有效性的随机对照试验。

DOI：
10.3109/02770900903560209
发表时间：
2010
期刊：
The Journal of asthma : official journal of the Association for the Care of Asthma
影响因子：
0
作者：
Le,TaoT;Rait,MichelleA;Jarlsberg,LeahG;Eid,NemrS;Cabana,MichaelD
通讯作者：
Cabana,MichaelD

Physician communication regarding cost when prescribing asthma medication to children.

医生在向儿童开哮喘药物时就费用进行沟通。