Encouraging a systems approach for adherence to national asthma guidelines

Purpose. There is a lack of information in the literature reflecting systems effects on adherence to national asthma guidelines. The purpose of this pilot study is to provide a descriptive account of the preparedness of academic primary care sites to follow national asthma guidelines related to spirometry, peak flowmeters, standard history forms, severity assessment, follow-up assessment sheets, patient self-assessment sheets, and asthma action plan templates. Methods. This was a cross-sectional descriptive study. A short survey was mailed to medical directors on behalf of primary care academic clinical sites to assess the availability of guideline tools in their practices. Medical directors were also asked to rate their perception of how essential the guidelines were in the management of asthma. Results. Medical directors agreed that the guideline tools were essential in managing asthma. However, with the exceptions of peak flow meters and standard history forms, most sites were not equipped with these tools for providers to use. Conclusions. The findings highlight the importance of the practice environment on the implementation of national asthma guidelines and encourage larger studies to include an assessment of the systems in place to enable guideline adherence. By taking systems into account, interventions may be potentially much more effective in improving the quality of care.