Use of written treatment plans for asthma by specialist physicians

• Published in: Pediatric pulmonology 2007-04, Vol.42 (4), p.348-356
• Main Authors: Sheares, Beverley J., Du, Yunling, Vazquez, Tara L., Mellins, Robert B., Evans, David
• Format: Article
• Language: English
• Subjects: Adult; allergists; Allergy and Immunology; asthma; Asthma - epidemiology; Asthma - therapy; asthma action plans; asthma self-management plans; Attitude of Health Personnel; Biological and medical sciences; children; Chronic obstructive pulmonary disease, asthma; Clinical Competence; Communication Barriers; Cross-Sectional Studies; Educational Status; Female; General aspects; Humans; Interviews as Topic; Male; Medical sciences; New York; patient autonomy; pediatrics; Personal Autonomy; Physician-Patient Relations; Pneumology; Practice Patterns, Physicians; Pulmonary Medicine; pulmonologists; Self Care; specialist physicians; Surveys and Questionnaires; written treatment plans
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.20586

Few studies have addressed use of written treatment plans (WTPs) for asthma by specialist physicians. The purpose of this study is to characterize the attitudes, beliefs, and self‐reported practice behaviors regarding asthma WTP use among specialist physicians. Structured interviews were conducted with pulmonologists and allergists who provide direct patient asthma care in two New York City medical centers. The interview covered five areas: (1) demographic information; (2) experiences with WTPs; (3) reported clinical practice behaviors; (4) factors influencing use of WTPs; and (5) physician–patient communication. Forty‐five physicians were eligible to participate in the study. Sixty‐eight percent of physicians treated adult patients while 32% were pediatric specialists. Forty‐four physicians completed interviews, (response rate of 98%). Eighty‐six percent indicated they use WTPs with at least some of their patients (71% of their patients had received a plan from them). Most reported handwriting plans on a blank piece of paper (66%). Most plans were symptom‐based (47%) or combined symptoms with peak flow measurement (50%). Most plans supported patient autonomy. More than 80% of physicians believe the use of a WTP improves patient outcomes. The results suggest that asthma specialists in this survey utilize WTPs more frequently than reported in other studies. Physicians encourage patient autonomy and believe asthma self‐management by patients improves their outcomes. Controlled studies of the efficacy of asthma management plans are needed to assess the impact of WTPs as used in clinical practice. Pediatr Pulmonol. 2007; 42:348–356. © 2007 Wiley‐Liss, Inc.