title: Asthma management practices in adults--findings from the German Health Update (GEDA) 2010 and the German National Health Interview and Examination Survey (DEGS1) 2008-2011.
abstract: OBJECTIVE
  In Germany, population-wide data on adherence to national asthma management guidelines are lacking, and performance measures (PM) for quality assurance in asthma care are systematically monitored for patients with German national asthma disease management program (DMP) enrollment only. We used national health survey data to assess variation in asthma care PM with respect to patient characteristics and care context, including DMP enrollment.
  
  
  METHODS
  Among adults 18-79 years with self-reported physician-diagnosed asthma in the past 12 months identified from a recent German National Health Interview Survey (GEDA 2010: N = 1096) and the German National Health interview and Examination Survey 2008-2011 (DEGS1: N = 333), variation in asthma care PM was analyzed using logistic regression analysis.
  
  
  RESULTS
  Overall, 38.4% (95% confidence interval: 32.5-44.6%) of adults with asthma were on current inhaled corticosteroid therapy. Regarding non-drug asthma management, low coverage was observed for inhaler technique monitoring (35.2%; 31.2-39.3%) and for provision of an asthma management plan (27.3%; 24.2-30.7%), particularly among those with low education. Specific PM were more complete among persons with than without asthma DMP enrollment (adjusted odds ratios ranging up to 10.19; 5.23-19.86), even if asthma patients were regularly followed in a different care context.
  
  
  CONCLUSIONS
  Guideline adherence appears to be suboptimal, particularly with respect to PM related to patient counseling. Barriers to the translation of recommendations into practice need to be identified and continuous monitoring of asthma care PM at the population level needs to be established.
authors.affiliation: a Department of Epidemiology and Health Monitoring , Robert Koch Institute , Berlin , Germany .|b Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin , Berlin , Germany , and.
authors.forename: Henriette
authors.initials: H
authors.lastname: Steppuhn
authors.affiliation: a Department of Epidemiology and Health Monitoring , Robert Koch Institute , Berlin , Germany .
authors.forename: Ute
authors.initials: U
authors.lastname: Langen
authors.affiliation: a Department of Epidemiology and Health Monitoring , Robert Koch Institute , Berlin , Germany .
authors.forename: Stephan
authors.initials: S
authors.lastname: Mueters
authors.affiliation: a Department of Epidemiology and Health Monitoring , Robert Koch Institute , Berlin , Germany .
authors.forename: Stefan
authors.initials: S
authors.lastname: Dahm
authors.affiliation: a Department of Epidemiology and Health Monitoring , Robert Koch Institute , Berlin , Germany .
authors.forename: Hildtraud
authors.initials: H
authors.lastname: Knopf
authors.affiliation: b Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin , Berlin , Germany , and.|c Institute for Clinical Epidemiology and Biometry, University of Würzburg , Würzburg , Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Keil
authors.affiliation: a Department of Epidemiology and Health Monitoring , Robert Koch Institute , Berlin , Germany .
authors.forename: Christa
authors.initials: C
authors.lastname: Scheidt-Nave
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005858:Germany; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D016540:Smoking Cessation; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents
keywords: Adult population; Germany; asthma; disease management; national health survey; performance measures; quality indicators