Physicians show lack of knowledge on latest updates to asthma management guidelines

SAN ANTONIO – According to a study presented at the American Academy of Allergy, Asthma & Immunology annual meeting, most physicians appeared unaware of updates to asthma management guidelines more than 6 months after their publication.

“Although we did not expect all physicians to know all parts of the guidelines, we were surprised that many of the key concepts and changes in the asthma management guidelines were not followed by a large percentage of physicians,” the study author said Alan Baptist, MD, MPH, FAAAAIassociate professor of allergy and immunology at the University of Michigan, Healio said.

As previously reported by Healio, the first changes were the 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Experts Panel Working Group, developed by the NIH and the National Heart, Lung, and Blood Institute to federal guidelines in more than a decade. They implemented new recommendations for six issues related to clinical asthma management, including the use of intermittent inhaled corticosteroids (ICS), additional long-acting muscarinic antagonists, and indoor allergen mitigation strategies.

Because guidelines “define the new standard of care to improve patient outcomes,” “assessment of physician familiarity with new guidelines can be a surrogate indicator for assessing the extent to which patients are receiving the most up-to-date care, which is what prompted us to conduct this study,” said Baptist.

To achieve assessments of understanding and familiarity, Baptist and colleagues at the Focused Updates Working Group issued eight-item questionnaires to 256 clinicians between June and October 2021, using different versions depending on whether the clinicians treated primarily adults or children.

Coming from eight states, primary care physicians made up 82% of the respondents, while 8.2% were pulmonologists and 5.1% were allergists.

Overall, the researchers reported an average knowledge score of 45.8% based on the total number of questions answered correctly.

Physicians seemed to score more above the median when treating only adults (P = .027) and have been in practice for more than 10 years (P = 0.01).

The top 20% of respondents seemed more likely to be allergists (P = .01) and are longer in practice (P = 0.017).

Although 62.5% of physicians reported having “at least some awareness” of the focused updates, the researchers found that this awareness did not correlate with values ​​above the median.

Notably, only 5.5% of clinicians were aware of guidelines recommending intermittent use of ICS and albuterol together in mild asthma, while only 16.4% correctly reported use of ICS as needed in children with asthma exacerbations.

Baptist acknowledged that without proper strategies and implementations to address the lack of understanding, it could take years for physicians to fully understand the key points of the guidelines and translate them into the clinical setting.

“Closing the knowledge gap among physicians is one of the most important steps required for guideline compliance and implementation,” he said. “A concerted effort must be made to educate and educate healthcare professionals about the new guidelines. The increasing use of technology, including electronic medical records and distance learning, could offer such opportunities, although more research is needed.”

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Annual Meeting of the American Academy of Allergy, Asthma & Immunology