Physicians show lack of knowledge on latest updates to asthma management guidelines
Click Here to Manage Email Alerts
SAN ANTONIO — Most physicians appeared unaware of updates to asthma management guidelines more than 6 months after their publication, according to a study presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.
“While we did not expect all physicians to know all parts of the guidelines, we were surprised that many of the key concepts and changes to the asthma management guidelines were not being followed by a large percentage of physicians,” study author Allan Baptist, MD, MPH, FAAAAI, associate professor of allergy and immunology at University of Michigan, told Healio.
As Healio previously reported, the 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Experts Panel Working Group, developed by the NIH and National Heart, Lung, and Blood Institute, were the first changes to the federal guidelines in more than a decade. They implemented new recommendations for six topics relating to clinical asthma management, including use of intermittent inhaled corticosteroids (ICS), add-on long-acting muscarinic antagonists and indoor allergen mitigation strategies.
Because guidelines “define the new standard of care to improve patient outcomes,” “assessing physician familiarity with new guidelines can be a surrogate marker for assessing how much patients are receiving the most up-to-date care, which is what prompted us to conduct this study,” Baptist said.
To achieve assessments of understanding and familiarity, Baptist and colleagues of the Focused Updates Working Group issued eight-item questionnaires to 256 clinicians between June and October 2021, using different versions based on whether the clinicians primarily treated adults or children.
Hailing from eight states, primary care physicians made up 82% of respondents, whereas 8.2% were pulmonologists and 5.1% were allergists.
Overall, researchers reported an average knowledge score of 45.8% based on total questions answered correctly.
Physicians appeared more likely to score above the median if they treated adults only (P = .027) and were in practice for more than 10 years (P = .01).
The top 20% of respondents appeared more likely to be allergists (P = .01) and have been in practice longer (P = .017).
Although 62.5% of the physicians reported “at least some awareness” of the focused updates, researchers found that such awareness did not correlate with scores above the median.
Notably, only 5.5% of clinicians were aware of guidance recommending using ICS and albuterol together intermittently for mild asthma, whereas only 16.4% were correct about using ICS as needed for children experiencing asthma exacerbations.
Baptist acknowledged that without proper strategies and implementations to address the lack of understanding, it could take years for physicians to fully understand the key points of the guidelines and translate them into the clinical setting.
“Narrowing the knowledge gap in physicians is one of the most important steps that need to happen for guideline adherence and implementation,” he said. “There needs to be concerted efforts on educating and training health care professionals on the new guidelines. The increasing use of technology, including electronic medical records and remote education, may provide such possibilities, although further research is needed.”