Are primary care physicians following National Institute of Allergy and Infectious Disease guidelines for the prevention of peanut allergy? A survey-based study
Are primary care physicians following National Institute of Allergy and Infectious Disease guidelines for the prevention of peanut allergy? A survey-based study
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DOI：
10.2500/aap.2020.41.200019
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发表时间：
2020-05-01
影响因子：
2.8
通讯作者：
Baptist, Alan P.
中科院分区：
文献类型：
--
作者：
Alvarez, Alicia;Gupta, Malika;Baptist, Alan P.
背景资料：2017年美国国家过敏和传染病研究所（NIAID）关于花生过敏预防指南的附录显著改变了对有花生过敏风险的患者的建议。这是未知的，如果初级保健医生都知道或遵循这些guidelines.Objective：要评估的知识和实践的NIAID指南之间的初级保健physics.Methods：一项调查，以评估的知识，意识和实践行为的NIAID指南。它被分发给两个大型学术中心的儿科、家庭医学和医学儿科住院医师和主治医生。回应进行了分析与二进制logistic regression.Results：调查分布到605供应商，与35%（n = 210）的响应率。平均得分为4.8分，7个问题回答正确。在参与者中，53%的人错误地建议鸡蛋过敏患者在家中引入花生。此外，40%的参与者错误地认为花生的最早引进年龄是>1岁。超过一半的参与者不知道新的指导方针。在逻辑回归分析中，与足够的知识评估得分相关的因素是对指南的了解（比值比[OR] 2.98（置信区间（CI），1.34-6.60），5年内从住院医师毕业（OR 3.60 195%CI，1.14-11.35），隶属于内科-儿科结论：基层卫生工作者对花生过敏预防相关问题的回答有三分之一不正确。提高对2017年NIAID指南的认识可能会提供改善患者结局的机会。迫切需要制定创新的教育战略，宣传这些准则。
Background: The 2017 addendum to the National Institute of Allergy and Infectious Diseases (NIAID) guidelines on peanut allergy prevention significantly altered recommendations for patients at risk of developing peanut allergies. It is unknown if primary care physicians are aware of or are following these guidelines.Objective: To assess the knowledge and practice of the NIAID guidelines among primary care physicians.Methods: A survey was developed to assess the knowledge, awareness, and practice behaviors of the NIAID guidelines. It was distributed to pediatric, family medicine, and medicine-pediatric residents and attending physicians at two large academic centers. Responses were analyzed with binary logistic regression.Results: The survey was distributed to 605 providers, with a response rate of 35% (n = 210). The average score was 4.8 of seven questions answered correctly. Of the participants, 53% incorrectly recommended at-home peanut introduction in patients with egg allergy. In addition, 40% of the participants incorrectly believed that the earliest age for peanut introduction was >1 year of age. More than half of the participants were unaware of the new guidelines. On logistic regression, factors associated with adequate knowledge assessment scores were awareness of the guidelines (odds ratio [OR] 2.98 (confidence interval (CI), 1.34-6.60]), graduation from residency within 5 years (OR 3.60 195% CI, 1.14-11.35]), and affiliation with the medicine-pediatrics department (OR 4.59 (95% CI, 1.07-19.65]).Conclusion: The primary care providers incorrectly answer one-third of the questions related to the prevention of peanut allergy. Increasing awareness of the 2017 NIAID guidelines may provide an opportunity to improve patient outcomes. There is an urgent need to develop innovative education strategies to publicize these guidelines.