Adherence to the 2007 cystic fibrosis pulmonary guidelines: a national survey of CF care centers.

Abstract:

OBJECTIVE:To examine cystic fibrosis (CF) physician adherence to the 2007 CF Foundation (CFF) Pulmonary Guidelines for Chronic Medications. Specifically adherence and barriers to prescribing level A medication recommendations (i.e., inhaled tobramycin and dornase alfa) and level B medication recommendations (i.e., macrolide antibiotics and hypertonic saline) were studied. METHODS:During Spring 2010, the CFF emailed survey invitations to directors of 136 accredited CF care centers treating 50+ CF patients. Directors were asked to forward the invitations to their physician colleagues. One hundred thirty-three surveys were included in the analyses, representing 92 centers. Barriers were conceptualized based on Cabana et al.'s framework for adherence to guidelines. Adherence was assessed via a case vignette. RESULTS:Logistic regression analysis revealed that higher outcome expectancy (OR = 1.099, CI 1.010-1.196) and fewer environmental/system barriers (OR = 1.484, CI 1.158-1.902) were significantly associated with Vignette Adherence. A trend for an association between Familiarity and Vignette Adherence (OR = 1.642, CI 0.953-2.828) was evident, while no demographic variables were significantly associated with Vignette Adherence. CONCLUSION:Targeting outcome expectancy and external barriers with multifaceted, ongoing interventions may improve guideline adherence. Pulmonologists are clearly looking for empirical evidence that these medications benefit their patients over the long-term and offset patient treatment burden with improved health.

journal_name

Pediatr Pulmonol

journal_title

Pediatric pulmonology

authors

Glauser TA,Nevins PH,Williamson JC,Abdolrasulnia M,Salinas GD,Zhang J,Debonnett L,Riekert KA

doi

10.1002/ppul.21573

subject

Has Abstract

pub_date

2012-05-01 00:00:00

pages

434-40

issue

5

eissn

8755-6863

issn

1099-0496

journal_volume

47

pub_type

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