Why Clinical Practice Guidelines Hinder Rather Than Help.
Asthma is the leading cause of hospitalization among children. Recognition of inadequate control of asthma stimulated the development of Guidelines by an Expert Panel convened by the National Asthma and Prevention Program of the National Institute of Health. Those Guidelines with several revisions spanning 24 years were well-intentioned but ineffective at altering the continued high prevalence of urgent care and hospitalization among children with asthma. Meanwhile, there is strong evidence that specialists, with their greater clinical experience and knowledge have demonstrated excellent outcome compared with non-specialist care. It is time to recognize that there is strong evidence-based data that asthma specialty programs and not Guidelines disseminated to generalists alter the outcome of asthma.
Professor Emeritus of Pediatrics, University of Iowa Children's Hospital, Iowa, Iowa City, Iowa, USA. Electronic address: miles-weinberger@uiowa.edu.
Miles
M
Weinberger
D001249:Asthma / Q000628:therapy*; D002648:Child; D003695:Delivery of Health Care / Q000379:methods*; D055317:Evidence-Based Practice / Q000379:methods / Q000592:standards; D006801:Humans; D010346:Patient Care Management / Q000592:standards*; D017410:Practice Guidelines as Topic; D058996:Quality Improvement; D014481:United States
asthma; guidelines; health care delivery