Pediatric Asthma Study of the State Medical Society of Wisconsin.
OBJECTIVE
Asthma management should follow evidence-based national guidelines. We compared patient self-reports of usual care to clinical practice guidelines.


METHODS
Cross-sectional survey of parents of 245 children age 2-14 years with asthma seen by physicians at 13 practices in Wisconsin.


RESULTS
Most children with asthma were atopic and a substantial number experienced psychosocial problems. Families infrequently used written care plans. Knowledge about asthma triggers, especially tobacco smoke, was deficient. Increasing asthma severity was associated with poorer health. Although most parents rated their physician's expertise as excellent or very good, one-third of children with persistent symptoms used no daily control medication. Significant differences were observed between primary care and specialty care with the best asthma self-management done by patients of specialists.


CONCLUSIONS
Care of Wisconsin children with asthma inconsistently follows national guidelines. They and their families require improved education, written care plans, appropriate medications, and psychosocial support.
Meurer
J R
JR
Community Pediatrics Center, Advancement of Urban Children, Medical College of Wisconsin and Children's Health System, USA.
Helstad
C P
CP
Wiegmann
S M
SM
Kelly
K J
KJ
Fisher
R
R
Bukstein
D
D
Wegehaupt
P
P
D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006302:Health Services Research; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D008297:Male; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care; D012720:Severity of Illness Index; D012955:Societies, Medical; D014922:Wisconsin