作者
Gregory B Diette, Cecilia M Patino, Barry Merriman, Laura Paulin, Kristin Riekert, Sande Okelo, Kathy Thompson, Jerry A Krishnan, Ruth Quartey, Deanna Perez-Williams, Cynthia Rand
发表日期
2007/7/9
期刊
Archives of internal medicine
卷号
167
期号
13
页码范围
1360-1366
出版商
American Medical Association
简介
Background
Asthma guidelines recommend severity assessment to assign treatment, often quantified as current control. It is unknown how strongly control assessment affects clinician treatment decisions, nor if control is sufficient.
Methods
To determine patient factors used by physicians to assign treatment, we surveyed pulmonary specialists (PSs) and family physicians (FPs) using vignettes. We tested whether recent acute care (hospitalization 6 months ago), bother (patient bothered by asthma), control (symptom or reliever medication frequency), and direction (change since last visit) influence treatment decisions. Factors used for stepping up and stepping down were assessed.
Results
A total of 461 physicians participated (236 PSs and 225 FPs). As expected, physicians indicated a greater likelihood of stepping up treatment for persistent (4-5 times per week) than for intermittent (1 time per 2 weeks) symptoms (PSs …
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GB Diette, CM Patino, B Merriman, L Paulin, K Riekert… - Archives of internal medicine, 2007