Survey of asthma practice among emergency physicians

Purpose: The National Asthma Education and Prevention Program (NAEPP) published guidelines for asthma management in 1991. The purpose of this study is to assess the concordance between emergency physicians' practice and the guidelines. Design: Survey mailed to emergency physicians. Nonrespondents were mailed a second copy of the survey. Participants: Eight hundred randomly selected active members of the American College of Emergency Physicians. Interventions: None. Measurements: Participants were asked questions regarding training, current asthma practices, and sources of information on asthma management. Results: Eight hundred questionnaires were mailed, of which 416 (52%) were returned. Sixty-four percent of respondents administer beta-agonists consistent with the NAEPP guidelines. Seventy-five percent of respondents administer corticosteroids in similar accord, while 75% prescribed outpatient corticosteroids in concordance with those recommendations. Forty-seven percent report measuring pretreatment pulmonary function more than half the time and only 38% report checking pulmonary function prior to disposition more than half the time. Conclusions: Most emergency physicians surveyed use beta-agonists and steroids at least as often as recommended. A minority of emergency physicians reported utilizing pulmonary function testing in the manner recommended by the NAEPP.