Facilitation improves PCP adherence to asthma guidelines

(HealthDay)—Adding practice facilitation (PF) to other strategies may improve adherence to asthma guidelines in the primary care setting, according to research published in the May/June issue of the Annals of Family Medicine.

James W. Mold, M.D., M.P.H., of the University of Oklahoma in Oklahoma City, and colleagues conducted a cluster randomized trial involving 1,016 patients in primary care practices. Independent and combined effects of PF and local learning collaboratives (LLCs), combined with performance feedback and academic detailing, were compared with performance feedback and academic detailing alone (control arm). The researchers assessed the impact of the interventions on adherence to six recommendations from asthma guidelines.

The researchers found, in unadjusted analyses, that the strategies significantly improved adherence to differing numbers of the six guideline recommendations as follows: control arm, two; PF arm, three; LLC arm, four; PF plus LLC arm, five. Evaluation with multivariate modeling showed that practices in the PF arm, compared with practices in the control arm, significantly improved assessment of asthma severity (odds ratio [OR], 2.5; 95 percent confidence interval [CI], 1.7 to 3.8) and assessment of asthma level of control (OR, 2.3; 95 percent CI, 1.5 to 3.5). Practices in the LLC arm, compared with practices in the control arm, did not significantly improve adherence to any of the guideline recommendations.

"Addition of PF to performance feedback and academic detailing was helpful to practices attempting to improve adherence to asthma guidelines," the authors write.

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