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Cited by 191Asthma and respiratory diseasesClinical practice guidelines implementationPrimary Care and Health Outcomes

Long-term effects of asthma education for physicians on patient satisfaction and use of health services

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Clark, N.M., Gong, M., Schork, M.a, Kaciroti, N, Evans, D, Roloff, D, Hurwitz, M, Maiman, L.a +1 more·2000·European Respiratory Journal
DOI 10.1034/j.1399-3003.2000.16a04.x
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Abstract

This randomized clinical trial evaluated the long-term impact of an interactive seminar for physicians based on principles of self-regulation on clinician behaviour, children's use of health services for asthma, and parent's views of physician performance. Seventy-four general practice paediatricians, and 637 of their asthma patients aged 1-12 yrs, were randomized to treatment or control. Children and parents were blind to physicians' participation. Data were collected at baseline and follow-up through self-administered surveys (paediatricians), telephone interviews (parents) and medical records. The seminar focused on development of communication and teaching skills and use of therapeutic medical regimens for asthma as outlined in the National Asthma Education and Prevention Program guidelines. Approximately 2 yrs postintervention, treatment group physicians were more likely than control physicians to: use protocols for delivering asthma education (odds ratio (OR) 4.9, p=0.2), write down for patients how to adjust medicines when symptoms change (OR 5.7, p=0.05), and provide more guidelines for modifying therapy (OR 3.8, p=0.06). Parents scored treatment group physicians higher than control physicians on five specific positive communication behaviours. Children seen by treatment group physicians had fewer hospitalizations (p=0.03) and those with higher levels of emergency department (ED) use at baseline had fewer subsequent ED visits (p=0.03). No differences regarding the number of office visits were noted. There were no significant differences found between treatment and control group physicians in the amount of time spent with patients during office visits (26 versus 29 min) or in the number of patients treated with anti-inflammatory medicine. It is concluded that interactive asthma seminars for paediatricians had significant long-term benefits for their asthma care.

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  • Only five studies appeared to be at high risk of bias from selective reporting.

    “Only five studies appeared to be at high risk of bias from selective reporting (Alamo 2002; Clark 2000; Fallowfield 2002; Haskard 2008; Pill 1998).”

    From Interventions for providers to promote a patient-centred approach in clinical consultations (2012) · cites this paper as Clark 2000

  • In the other 19 studies, it was either unlikely or unclear that an ITT approach had been used.

    “In the other 19 studies, it was either unlikely or unclear that this approach had been used (Alder 2007; Clark 2000; Dijkstra 2006; Harmsen 2005; Haskard 2008; Heaven 2006; Krones 2008; Langewitz 1998; Levinson 1993; Lewis 1991; Loh 2007; Longo 2006; McLean 2004; Merckaert 2008; Pill 1998; Putnam 1988; Smith 1998; Stewart 2007; Wolf 2008).”

    From Interventions for providers to promote a patient-centred approach in clinical consultations (2012) · cites this paper as Clark 2000

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Research works printed but not linked: 2

  1. Inui TS, Yourtee EL, Williamson JW. Improving out- comes in hypertension after physician tutorials. Ann In- tern Med 1976; 84: 646±651.
  2. National Heart, Lung, and Blood Institute. Asthma management in minority children: practical insights for clinicians, researchers, and public health planners. NIH publication No. 95-3675, 1995; pp. 13, 48±49.

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Authors
Clark, N. M., Gong, M., Schork, M. A., Kaciroti, N., Evans, D., Roloff, D., Hurwitz, M., Maiman, L. A., & Mellins, R. B.
Affiliations
University of Michigan (US)
ORCID
Venue
European Respiratory Journal
Publisher
European Respiratory Society (ERS)
Published
2000-07
Volume
16
Issue
1
Pages
15-21
ISSN
  • 0903-1936 (ISSN-L)
  • 1399-3003
DOI
10.1034/j.1399-3003.2000.16a04.x
OpenAlex
W2150346814
Cited by
191
References
17
Citations by year
2025: 3 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 6 · 2015: 3 · 2014: 7 · 2013: 6 · 2012: 5
FWCI
4.08
Type
journal article
Language
en
Open access
Locations
  • European Respiratory Journal (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Arnold P. Gold Foundation
  • National Institutes of Health (5r01hl044976-05)
  • National Heart, Lung, and Blood Institute (HL-44976)
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Keywords
asthma education, physician training, childhood asthma, patient satisfaction, health care utilization, hospitalization, emergency department visits, physician-patient communication, self-regulation, asthma guidelines, long-term outcomes
MeSH terms
Adult, Asthma, Child, Child, Preschool, Communication, Education, Medical, Continuing, Female, Health Services, Humans, Infant, Male, Middle Aged, Parents, Pediatrics, Physician-Patient Relations, Patient Satisfaction

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