Q:

6/8/2014
I am NP who is studying asthma for her dissertation. I am having difficulty locating a reliable and valid instrument that measures physician and NP knowledge of asthma. Could you please recommend a questionnaire that assess' physician (or NP) knowledge of asthma? The ones I found are outdated or have poor psychometric properties.

A:

Thank you for your inquiry.

I am not sure that I can be of help to you in this regard other than sending you references to the assessment of physicians' knowledge regarding asthma and regarding adherence to guidelines. Below you will find the assessments of which I am aware, and a link to a website which will allow you to access these assessments as well as two abstracts which discuss knowledge of guidelines for asthma and the adherence of physicians to these guidelines. These abstracts will also give you an extensive bibliography on the topic.

BMC Medical Education (2001) 1:2


BRMesCea Mrcehd iacratlic Eleducation (2001) 1:2. Assessing the knowledge of bronchial asthma among primary health care physicians in Crete: A pre- and post-test following an educational course Emmanouil Rovithis*1, Christos Lionis1,2, Sofia E Schiza3, Dimosthenis Bouros3, Antonis Karokis1, loannis Vlachonikolis4 and Nikolaos M Siafakas3

Asthma Guidelines: An Assessment of Physician Understanding and Practice
Kevin C. Doerschug, Michael W. Peterson, Charles S. Dayton, and Joel N. Kline. Am J Respir Crit Care Med 1999;159:1735–1741.

Knowledge of the asthma guidelines among doctors in a tertiary hospital in Nigeria.
Indian Journal of Allergy, Asthma and Immunology, Jul-Dec 2012, Volume 26, Issue 2

Allergy Asthma Proc. 2012 Jan-Feb;33(1):65-76. doi: 10.2500/aap.2011.32.3521. Epub 2011 Dec 15.
Comparison of the Asthma in America and Asthma Insight and Management surveys: did asthma burden and care improve in the United States between 1998 and 2009?
Nathan RA1, Meltzer EO, Blaiss MS, Murphy KR, Doherty DE, Stoloff SW.
Author information
1Asthma and Allergy Associates, P.C., and Research Center, Colorado Springs, Colorado, USA.
Abstract
Significant changes in asthma treatment guidelines and therapies occurred between the period of time in which the Asthma in America (AIA) and Asthma Insight and Management (AIM) surveys were conducted: 1998 and 2009, respectively. This study compares asthma burden and management in 1998 and 2009. Both surveys were telephone based and conducted across the United States. The AIA survey included 2509 patients with asthma (aged <1 year to 89 years old), 512 physicians, and 1000 adults from the general population. The AIM survey included 2500 patients (aged =12 years), 309 physicians, and 1090 adults from the general population. Patient responses were weighted to match the entire population of U.S. patients with asthma. The impact of asthma burden and care on the general population and on asthma patients was slightly lower or unchanged in the AIM survey versus the AIA survey. Acute care use (hospitalizations, emergency department visits, or other urgent care visits) was common in AIA (36%) and AIM (34%) surveys. Most physicians were aware of guidelines in AIA (90%) and AIM (96%), but fewer "always" followed them (AIA, 36%; AIM, 28%). Spirometry was often used to aid in diagnosis by asthma care specialists (AIA, 73%; AIM, 76%) but infrequently by nonsubspecialists (AIA, 27%; AIM, 38%). Most physicians prescribed inhaled corticosteroids (ICSs) for mild (AIA, 70%; AIM, 83%) or moderate (AIA, 89%; AIM, 83%) persistent asthma. In the AIM survey, 38% of specialists prescribed ICSs combined with a long-acting ß2-agonist for moderate asthma. The state of U.S. asthma care and clinical outcomes changed little from 1998 to 2009.

Allergy Asthma Proc. 2012 Jan-Feb;33(1):54-64. doi: 10.2500/aap.2011.32.3518. Epub 2011 Dec 15.
Asthma management and control in the United States: results of the 2009 Asthma Insight and Management survey.
Murphy KR1, Meltzer EO, Blaiss MS, Nathan RA, Stoloff SW, Doherty DE.
Author information
1Boys Town National Research Hospital, Boys Town, Nebraska 68010, USA.
Abstract
Past asthma surveys have shown suboptimal management and control of asthma in the United States. No major survey of asthma management has been conducted since the Third Expert Panel Report for the National Asthma Education and Prevention Program (NAEPP) guidelines on diagnosis and treatment of asthma (August 2007). This study was designed to report asthma management and control results from the Asthma Insight and Management survey of U.S. patients and physicians. A telephone-based survey was conducted during 2009 in 2500 patients with asthma, aged =12 years, and 309 physicians (104 allergists, 54 pulmonologists, 101 family practitioners, and 50 internists). Patients' asthma control perceptions (71% "completely controlled" or "well controlled") were inconsistent with their NAEPP control level as determined by self-reported symptoms (29% well controlled). Patients and physicians had low expectations for effective asthma management; patients considered asthma well managed if rescue medication was used three times per week (46%), urgent care visits occurred twice per year (67%), or emergency department visits occurred once per year (60%). Asthma-related syncope, seizure, intensive care unit admission, and intubation were associated with uncontrolled asthma based on NAEPP guidelines. Respiratory specialists (allergists/pulmonologists) implemented asthma management recommendations more than other physicians surveyed. However, only 22% of patients visited a specialist for usual asthma care and 48% had never visited a specialist. Despite detailed NAEPP guidance, asthma management and control in U.S. patients is unsatisfactory. Improved asthma control assessment (impairment and risk) and implementation of NAEPP management recommendations are needed to improve asthma control and outcomes.

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology