title: Improving quality of care and guideline adherence for asthma through a group self-assessment module.
abstract: BACKGROUND
  The quality of care for asthma remains suboptimal. Compliance with guidelines remains low, but improved adherence to guidelines may increase the quality of care. but. We conducted a trial to determine whether group Self-Assessment Module (SAM) activities led by a facilitator and conducted as part of Maintenance of Certification for Family Physicians (MC-FP) would increase knowledge of and adherence to asthma guidelines.
  
  
  METHODS
  Participating physicians completed audits of the charts of patients with asthma before and 6 months after a group SAM. Surveys of physicians' knowledge of asthma guidelines were administered immediately before, immediately after, and 6 months after the group SAM. We tested for differences in knowledge of and adherence to guidelines before and after the SAM using χ(2) and t tests.
  
  
  RESULTS
  Thirty-eight physicians in Virginia completed the SAM and had complete data. Participants completed more MC-FP activities than other physicians but were comparable in other characteristics. Except for prescribing controller medications for persistent asthma, all other quality measures significantly improved 6 months after the group SAM. Diagnosis by severity improved from 48.3% to 80.2%, and the use of action plans increased from 8.1% to 54.1%. Physicians' knowledge of guidelines improved immediately after the SAM and was sustained at 6 months. Increased knowledge translated into clinical skills: 30% of participants reported comfort with assessing control after the SAM, which increased to 97.5% 6 months after the SAM.
  
  
  CONCLUSIONS
  Group SAMs may be an effective method to increase physicians' knowledge of and adherence to clinical guidelines.
authors.affiliation: Family Medicine of Albemarle, Charlottesville, VA; Department of Family Medicine and Population Health, the Virginia Commonwealth University, Richmond; The American Board of Family Medicine, Lexington, KY; the Department of Family and Community Medicine, University of Kentucky College of Medicine, Lexington; and the Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine and Research Institute, Roanoke.
authors.forename: Kurt
authors.initials: K
authors.lastname: Elward
authors.forename: Brenna
authors.initials: B
authors.lastname: Blackburn
authors.forename: Lars E
authors.initials: LE
authors.lastname: Peterson
authors.forename: Mark
authors.initials: M
authors.lastname: Greenawald
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hagen
mesh_terms: D000328:Adult; D001249:Asthma / Q000628:therapy*; D002568:Certification; D005194:Family Practice; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012647:Self-Assessment
keywords: Asthma; Certification; Educational Assessment; Guideline Adherence