Enablers of Physician Prescription of a Long-Term Asthma Controller in Patients with Persistent Asthma

Objective. We aimed to identify key enablers of physician prescription of a long-term controller in patients with persistent asthma. Methods. We conducted a mailed survey of randomly selected Quebec physicians. We sent a 102-item questionnaire, seeking reported management regarding one of 4 clinical...

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Main Authors: Francine M. Ducharme, Alexandrine J. Lamontagne, Lucie Blais, Roland Grad, Kim L. Lavoie, Simon L. Bacon, Martha L. McKinney, Eve Desplats, Pierre Ernst
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Canadian Respiratory Journal
Online Access:http://dx.doi.org/10.1155/2016/4169010
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author Francine M. Ducharme
Alexandrine J. Lamontagne
Lucie Blais
Roland Grad
Kim L. Lavoie
Simon L. Bacon
Martha L. McKinney
Eve Desplats
Pierre Ernst
author_facet Francine M. Ducharme
Alexandrine J. Lamontagne
Lucie Blais
Roland Grad
Kim L. Lavoie
Simon L. Bacon
Martha L. McKinney
Eve Desplats
Pierre Ernst
author_sort Francine M. Ducharme
collection DOAJ
description Objective. We aimed to identify key enablers of physician prescription of a long-term controller in patients with persistent asthma. Methods. We conducted a mailed survey of randomly selected Quebec physicians. We sent a 102-item questionnaire, seeking reported management regarding one of 4 clinical vignettes of a poorly controlled adult or child and endorsement of enablers to prescribe long-term controllers. Results. With a 56% participation rate, 421 physicians participated. Most (86%) would prescribe a long-term controller (predominantly inhaled corticosteroids, ICS) to the patient in their clinical vignette. Determinants of intention were the recognition of persistent symptoms (OR 2.67), goal of achieving long-term control (OR 5.31), and high comfort level in initiating long-term ICS (OR 2.33). Decision tools, pharmacy reports, reminders, and specific training were strongly endorsed by ≥60% physicians to support optimal management. Physicians strongly endorsed asthma education, lung function testing, specialist opinion, accessible asthma clinic, and paramedical healthcare professionals to guide patients, as enablers to improve patient adherence to and physicians’ comfort with long-term ICS. Interpretation. Tools and training to improve physician knowledge, skills, and perception towards long-term ICS and resources that increase patient adherence and physician comfort to facilitate long-term ICS prescription should be considered as targets for implementation.
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spelling doaj-art-80238f19d12f40f2a45622b0f935ebe02025-02-03T01:00:33ZengWileyCanadian Respiratory Journal1198-22411916-72452016-01-01201610.1155/2016/41690104169010Enablers of Physician Prescription of a Long-Term Asthma Controller in Patients with Persistent AsthmaFrancine M. Ducharme0Alexandrine J. Lamontagne1Lucie Blais2Roland Grad3Kim L. Lavoie4Simon L. Bacon5Martha L. McKinney6Eve Desplats7Pierre Ernst8Department of Pediatrics, University of Montreal, Montreal, QC, H3T 1C5, CanadaClinical Research and Knowledge Transfer Unit on Childhood Asthma, Research Centre, CHU Sainte-Justine, Montreal, QC, H3T 1C5, CanadaDepartment of Pharmacology, University of Montreal, Montreal, QC, H3T 1J4, CanadaDepartment of Family Medicine, McGill University, Montreal, QC, H3T 1E2, CanadaMontreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montreal, Montreal, QC, H4J 1C5, CanadaMontreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montreal, Montreal, QC, H4J 1C5, CanadaClinical Research and Knowledge Transfer Unit on Childhood Asthma, Research Centre, CHU Sainte-Justine, Montreal, QC, H3T 1C5, CanadaResearch Centre, CHU Sainte-Justine, Montreal, QC, H3T 1C5, CanadaDivisions of Clinical Epidemiology and of Pulmonary Medicine, Department of Medicine, Jewish General Hospital, Montreal, QC, H3T 1E2, CanadaObjective. We aimed to identify key enablers of physician prescription of a long-term controller in patients with persistent asthma. Methods. We conducted a mailed survey of randomly selected Quebec physicians. We sent a 102-item questionnaire, seeking reported management regarding one of 4 clinical vignettes of a poorly controlled adult or child and endorsement of enablers to prescribe long-term controllers. Results. With a 56% participation rate, 421 physicians participated. Most (86%) would prescribe a long-term controller (predominantly inhaled corticosteroids, ICS) to the patient in their clinical vignette. Determinants of intention were the recognition of persistent symptoms (OR 2.67), goal of achieving long-term control (OR 5.31), and high comfort level in initiating long-term ICS (OR 2.33). Decision tools, pharmacy reports, reminders, and specific training were strongly endorsed by ≥60% physicians to support optimal management. Physicians strongly endorsed asthma education, lung function testing, specialist opinion, accessible asthma clinic, and paramedical healthcare professionals to guide patients, as enablers to improve patient adherence to and physicians’ comfort with long-term ICS. Interpretation. Tools and training to improve physician knowledge, skills, and perception towards long-term ICS and resources that increase patient adherence and physician comfort to facilitate long-term ICS prescription should be considered as targets for implementation.http://dx.doi.org/10.1155/2016/4169010
spellingShingle Francine M. Ducharme
Alexandrine J. Lamontagne
Lucie Blais
Roland Grad
Kim L. Lavoie
Simon L. Bacon
Martha L. McKinney
Eve Desplats
Pierre Ernst
Enablers of Physician Prescription of a Long-Term Asthma Controller in Patients with Persistent Asthma
Canadian Respiratory Journal
title Enablers of Physician Prescription of a Long-Term Asthma Controller in Patients with Persistent Asthma
title_full Enablers of Physician Prescription of a Long-Term Asthma Controller in Patients with Persistent Asthma
title_fullStr Enablers of Physician Prescription of a Long-Term Asthma Controller in Patients with Persistent Asthma
title_full_unstemmed Enablers of Physician Prescription of a Long-Term Asthma Controller in Patients with Persistent Asthma
title_short Enablers of Physician Prescription of a Long-Term Asthma Controller in Patients with Persistent Asthma
title_sort enablers of physician prescription of a long term asthma controller in patients with persistent asthma
url http://dx.doi.org/10.1155/2016/4169010
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