The Resource Interventions to modify health care provider adherence to asthma guidelines, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Johns Hopkins University Evidence-based Practice Center ; investigators, Sande O. Okelo, M.D., Ph.D., Arlene M. Butz, Sc.D., R.N., C.R.N.P., Ritu Sharma, B.Sc., Gregory B. Diette, M.D., M.H.S., Samantha I. Pitts, M.D., M.P.H., Tracy M. King, M.D., M.P.H., Shauna T. Linn, B.A., Manisha Reuben, B.S., Yohalakshmi Chelladurai, M.B.B.S., M.P.H., and Karen A. Robinson, Ph.D

Interventions to modify health care provider adherence to asthma guidelines, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Johns Hopkins University Evidence-based Practice Center ; investigators, Sande O. Okelo, M.D., Ph.D., Arlene M. Butz, Sc.D., R.N., C.R.N.P., Ritu Sharma, B.Sc., Gregory B. Diette, M.D., M.H.S., Samantha I. Pitts, M.D., M.P.H., Tracy M. King, M.D., M.P.H., Shauna T. Linn, B.A., Manisha Reuben, B.S., Yohalakshmi Chelladurai, M.B.B.S., M.P.H., and Karen A. Robinson, Ph.D

Label
Interventions to modify health care provider adherence to asthma guidelines
Title
Interventions to modify health care provider adherence to asthma guidelines
Statement of responsibility
prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Johns Hopkins University Evidence-based Practice Center ; investigators, Sande O. Okelo, M.D., Ph.D., Arlene M. Butz, Sc.D., R.N., C.R.N.P., Ritu Sharma, B.Sc., Gregory B. Diette, M.D., M.H.S., Samantha I. Pitts, M.D., M.P.H., Tracy M. King, M.D., M.P.H., Shauna T. Linn, B.A., Manisha Reuben, B.S., Yohalakshmi Chelladurai, M.B.B.S., M.P.H., and Karen A. Robinson, Ph.D
Title variation
Effective health care program
Creator
Contributor
Author
Issuing body
Subject
Genre
Language
eng
Summary
OBJECTIVES: To synthesize the published literature on the effect of interventions designed to improve health care providers' adherence to asthma guidelines on: (1) health care process outcomes (Key Question 1); (2) clinical outcomes (Key Question 2); (3) health care processes that subsequently impact clinical outcomes (Key Question 3). DATA SOURCES: Reports of studies from MEDLINE(r), Embase(r), Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL(r)), Educational Resources Information Center (ERICsm), PsycINFO(r), and Research and Development Resource Base in Continuing Medical Education (RDRB/CME), up to July 2012. REVIEW METHODS: Paired investigators independently reviewed each title, abstract, and full-text article to assess eligibility. Only comparative studies were eligible. Investigators abstracted data sequentially and independently graded the evidence. RESULTS: A total of 73 studies were eligible for review. A slight majority of studies were conducted in the U.S. (n=38). We classified studies as assessing eight types of interventions: decision support, organizational change, feedback and audit, clinical pharmacy support, education only, quality improvement (QI)/pay-for-performance, multicomponent, and information only. Half of the studies were randomized trials (n=34), 29 were pre-post, and the remaining 10 were a variety of nonrandomized study designs. The studies took place exclusively in primary care settings. The most frequently cited health care process outcome was prescription of asthma controller medication (n=41), followed by provision of an asthma action plan (n=18), prescription of a peak flow meter (n=17), and self-management education (n=12). Common clinical outcomes included emergency department (ED) visits (n=30) and hospitalizations (n=27), followed by use of short-acting ø2 agonists (n=9), missed school days (n=8), lung function tests (n=6), symptom days (n=6), quality of life (n=5), and urgent doctor visits (n=5). We identified 4 critical outcomes for which 68 studies provided information. There was moderate evidence for increased prescriptions of asthma controller medications using decision support, feedback and audit, and clinical pharmacy support interventions and low grade evidence for organizational change, multicomponent interventions. Moderate evidence supports the use of decision support and clinical pharmacy interventions to increase provision of patient self-education/asthma action plans; for the same outcome, low grade evidence supports the use of organizational change, feedback and audit, education only, quality improvement, and multicomponent interventions. Moderate grade evidence supports use of decision support tools to reduce ED visits/hospitalizations while low grade evidence suggests there is no benefit associated with organizational change, education only, and QI/pay-for-performance. Organizational change interventions provided no benefit for lost days of work/school. The evidence for the remainder of interventions was insufficient or low in strength. CONCLUSIONS: There is low to moderate evidence to support the use of decision support tools, feedback and audit, and clinical pharmacy support to improve the adherence of health care providers to asthma guidelines, as measured through health care process outcomes, and to improve clinical outcomes. There is a need to further evaluate health care provider-targeted interventions with a focus on standardized measures of outcomes and more rigorous study designs
Member of
Cataloging source
NLM
http://library.link/vocab/creatorName
Okelo, Sande O
Funding information
Conducted by the Johns Hopkins University Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ)
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • surveys of literature
NLM call number
WF 553
http://library.link/vocab/relatedWorkOrContributorDate
active 2011
http://library.link/vocab/relatedWorkOrContributorName
  • Butz, Arlene
  • Sharma, Ritu
  • Diette, Gregory B.
  • Pitts, Samantha I.
  • King, Tracy M.
  • Linn, Shauna T.
  • Reuben, Manisha
  • Chelladurai, Yohalakshmi
  • Robinson, Karen A.
  • United States
  • Johns Hopkins University
  • Effective Health Care Program (U.S.)
Series statement
  • Comparative effectiveness review
  • AHRQ publication
Series volume
  • number 95
  • No. 13-EHC022-EF
http://library.link/vocab/subjectName
  • Asthma
  • Outcome and Process Assessment (Health Care)
http://bibfra.me/vocab/relation/supportingbody
  • SGEpYsXqBGk
  • RzTDSdffmEM
Label
Interventions to modify health care provider adherence to asthma guidelines, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Johns Hopkins University Evidence-based Practice Center ; investigators, Sande O. Okelo, M.D., Ph.D., Arlene M. Butz, Sc.D., R.N., C.R.N.P., Ritu Sharma, B.Sc., Gregory B. Diette, M.D., M.H.S., Samantha I. Pitts, M.D., M.P.H., Tracy M. King, M.D., M.P.H., Shauna T. Linn, B.A., Manisha Reuben, B.S., Yohalakshmi Chelladurai, M.B.B.S., M.P.H., and Karen A. Robinson, Ph.D
Instantiates
Publication
Note
"May 2013."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier.
Content category
text
Content type code
txt
Content type MARC source
rdacontent.
Control code
855729986
Extent
1 online resource (381 pages)
Form of item
online
Media category
online
Media MARC source
rdamedia.
Media type code
c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)855729986
Label
Interventions to modify health care provider adherence to asthma guidelines, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Johns Hopkins University Evidence-based Practice Center ; investigators, Sande O. Okelo, M.D., Ph.D., Arlene M. Butz, Sc.D., R.N., C.R.N.P., Ritu Sharma, B.Sc., Gregory B. Diette, M.D., M.H.S., Samantha I. Pitts, M.D., M.P.H., Tracy M. King, M.D., M.P.H., Shauna T. Linn, B.A., Manisha Reuben, B.S., Yohalakshmi Chelladurai, M.B.B.S., M.P.H., and Karen A. Robinson, Ph.D
Publication
Note
"May 2013."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier.
Content category
text
Content type code
txt
Content type MARC source
rdacontent.
Control code
855729986
Extent
1 online resource (381 pages)
Form of item
online
Media category
online
Media MARC source
rdamedia.
Media type code
c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)855729986

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