Decreasing frequency of asthma education in primary care.
BACKGROUND
Provision of asthma education is associated with decreased hospitalizations and emergency department visits for patients with asthma. Our objective was to describe national trends in the provision of asthma education by primary care physicians in office settings.


METHODS
We used the National Ambulatory Medical Care Survey, a nationally representative dataset of patient visits to office-based physicians. We identified visits to primary care physicians for patients where asthma was a reason for the visit (asthma-related visits) or who had a diagnosis of asthma, but asthma was not a specific reason for the visit (asthma-unrelated visits) and estimated the percentage of visits where asthma education was provided. Data were available for asthma-related visits from 2001-2006 and from 2005-2006 only for asthma-unrelated visits. We examined time trends in asthma education and used multivariable logistic regression to identify independent patient and system-related factors that were predictors of asthma education.


RESULTS
The percentage of asthma-related visits where asthma education was provided declined during the study period, from 50% in 2001-2002 to 38% in 2005-2006 (p = 0.03). Asthma education was provided less frequently during asthma-unrelated visits compared to asthma-related visits (12% vs. 38%, p<0.0001). Independent predictors of providing asthma education included age < or = 18 years, receipt of a controller medication, incorporation of an allied health professional during the visit, longer visit duration and Northeast region.


CONCLUSIONS
Asthma education is underused by primary care physicians and rates have declined from 2001-2006. Interventions designed to promote awareness and greater use of asthma education are needed.
Hersh
Adam L
AL
Division of General Pediatrics, Department of Pediatrics, University of California, San Francisco, California, USA. hershad@peds.ucsf.edu
Orrell-Valente
Joan K
JK
Maselli
Judith H
JH
Olson
Lynn M
LM
Cabana
Michael D
MD
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000488:Allied Health Personnel / Q000706:statistics & numerical data; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000517:prevention & control / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005843:Geography / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D009819:Office Visits / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000706:statistics & numerical data* / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D055656:Prescriptions / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States; D055815:Young Adult
D018927:Anti-Asthmatic Agents