A short-term educational program improved physicians' adherence to guidelines for COPD and asthma in Shanghai.
BACKGROUND
Chronic pulmonary diseases such as chronic obstructive pulmonary disease (COPD) and asthma exert increasing burden on society while the management of them is far from adequate. The objective of this study is to evaluate adherence to guidelines through a patient study, and then investigate the effects of a short-term quality improvement educational program among clinicians in Shanghai, China.


METHODS
A prescription survey was performed in a random sample of 100 COPD and asthma outpatients to assess their pharmacological therapy. Then, an educational program was conducted in young pulmonary physicians from 83 hospitals in Shanghai. The training course was divided into 7 sessions of 2 hours delivered over 4 days from July 2010 to August 2011. Three months later, all of the participants were asked to take a written examination to assess the efficiency of training.


RESULTS
Prescription survey among the patients indicated the prescriptions are not consistent with the recommendations of current GOLD and GINA guidelines. The mainly existing issue is the overuse of inhaled glucocorticosteroid. For the educational program, 161 pulmonary physicians have attended the training course, and 110 clinicians finished the tests with an attendance rate of 68.3%. Although most of the clinicians recognized the increasing burden of COPD and asthma, they do not know well about the core elements of guidelines and their clinical practice is not fully in agreement with current recommendations. Through crossover comparison, our results suggested clinicians' knowledge of the guidelines was improved after training.


CONCLUSIONS
We concluded that application of continuous educational programs among physicians might promote their adherence to guidelines, and by that improve the quality of healthcare.
Department of Pulmonary Medicine, Research Institute of Respiratory Disease, Fudan University, Zhongshan Hospital, Shanghai, 200032, PR China. xiangdong.wang@telia.com.
Xiaocong
X
Fang
Shanqun
S
Li
Lei
L
Gao
Naiqing
N
Zhao
Xiangdong
X
Wang
Chunxue
C
Bai