Indicators of Non-adherence to Asthma Treatment in Pediatric Primary Care
Indicators of Non-adherence to Asthma Treatment in Pediatric Primary Care
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DOI：
10.1016/j.pedn.2017.04.011
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发表时间：
2017-09-01
影响因子：
2.4
通讯作者：
Nealis, Rose M.
中科院分区：
文献类型：
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作者：
Monti, Marcela D.;Nealis, Rose M.
目的：慢性病管理是一个持续的挑战，因为许多儿童疾病需要初级保健提供者进行复杂的医疗管理。哮喘就是这样一种疾病，今天有证据支持以初级保健为基础的管理策略，这将使哮喘患者终生受益。本研究旨在找到显着的指标，哮喘非坚持在儿科初级保健，在医疗家庭model.Design和方法的利用潜力：潜在的指标包括在一个图表审查过程中的一个大的美国东南部的初级保健儿科实践进行了审查，从上一个日历年的哮喘患者。这项研究回顾性地着眼于六个指标的发病率与哮喘相关的急诊科就诊和住院，以及临床相关associations.Results.Strong协会错过预约的数量被发现急诊科就诊和住院和许多指标的不遵守具有高度的统计学意义。未发现之间的关联错过的约会和选定的indicators.Conclusions：从收集的患者信息进行的数据分析，可以帮助指导实践中进一步讨论的主题。结果进行了分析，并报告给实践中审查的建议，一个新的医疗家庭哮喘文件协议，是在发展中。(C)2017爱思唯尔公司All rights reserved.
Purpose: Chronic disease management represents an ongoing challenge, as many childhood illnesses require complex medical management by primary care providers. Asthma is one such illness, and today there is evidence to support primary care-based management strategies that will benefit patients with asthma throughout a lifetime. This study seeks to find significant indicators of asthma non-adherence in pediatric primary care, with potential for utilization in the medical home model.Design and Methods: Potential indicators included in a chart review process of one large Southeastern U.S. primary care pediatric practice were reviewed from the previous calendar year for asthma patients. The study retroactively looks at the incidence of six indicators in relation to asthma-related emergency department visits and hospitalizations, and number of missed appointments for clinically relevant associations.Results: Strong associations were found between emergency department visits and hospitalizations and many of the indicators of non-adherence with high statistical significance. No associations were found between number of missed appointments and the selected indicators.Conclusions: The data analysis performed from the collected patient information can be helpful to guide practices in further discussions on the topic. Results were analyzed and reported to the practice in review as recommendations for a new medical home asthma documentation protocol that is in development. (C) 2017 Elsevier Inc. All rights reserved.