Background: Asthma affects 6 million children under 18 years of age producing a significant burden on the healthcare system and highlighting the importance of providers’ knowledge in asthma management. The 1993 National Asthma Education and Prevention Program created clinical practice guidelines established by the National Institute of Health (NIH) which included information regarding asthma care with the aim of improving outcomes. Inclusion of these guidelines in clinical practice remained low due to lack of provider’s awareness and knowledge, the guideline’s complexity, job satisfaction, and access to care and reimbursement. In 2020 new NIH asthma guidelines were established. Objective: Assess providers’ use of the 2020 NIH asthma guidelines in their clinical practice. Design/Methods: Cross-sectional survey regarding the 2020 NIH asthma guidelines was disseminated among Pediatric (PED) and Emergency Medicine (EM) residents and attending physicians in New York State. Results: 70 subjects participated in the study: 50 PED and 20 EM. 16 % PED and 10% EM subjects correctly responded to the question about the use of inhaled corticosteroids (ICS) in patients younger than 4 years of age with mild to moderate asthma. 20% PED and 30% EM correctly responded to the question about ICS use in patients older than 4 years of age with moderate to severe persistent asthma. 16% PED and 10% EM correctly responded to the question about long-acting beta agonist (LABA) use in patients 12 years and older with uncontrolled persistent asthma. 64% PED and 30%ED correctly responded to the question about ICS and short acting beta agonist use in patients 12 years old and older with mild persistent asthma. 60% from PED and 95% from EM responded correctly that LAMA can be added to ICS-LABA therapy if symptoms are not well controlled ( < 0.05). There was no correlation between the year of training and the level of knowledge among providers.
Conclusion(s): This study found that only a small percentage of PED and EM providers answered the survey questions accurately. Notably, there was an absence of correlation between the level of training and the correctness of responses. These findings underscore a noteworthy gap in the awareness of recent revisions to the NIH asthma guidelines within the community of PED and EM physicians responsible for the care of pediatric asthma patients. Limited usage of these guidelines could be responsible for poor outcomes in patient with asthma. Effective strategies are needed to help improve guidelines use with the ultimate goal of improving patient care.
