Special articleEffects of physician-related factors on adult asthma care, health status, and quality of life☆
Section snippets
Asthma disability subject enrollment
Patients with asthma were enrolled from the practices of 57 pulmonary specialists and 17 allergy and immunology specialists from 1992 to 1994 and from 34 family practitioners in 1996 14, 15. Physicians were selected randomly from all certified specialists in internal medicine and pulmonology (n = 252), internal medicine and allergy and immunology (n = 40), or family practice (n = 2041) in northern California. Patient eligibility was limited to an age range of 18 to 50 years. Physicians
Results
Most physicians were men who had been in practice for many years (Table 1) ; only 1 in 5 had graduated from medical school within 15 years of the survey. Pulmonary and allergy subspecialists accounted for slightly more than half of those surveyed.
Pulmonary specialty training was associated with the likelihood of being a high-frequency prescriber for each of the medications analyzed, although this was not statistically significant for long-acting beta-agonists (Table 2). Physicians in HMO- or
Discussion
We found that pulmonary physicians were more likely to report being high-frequency prescribers of specific asthma medications, whereas physicians in HMO- or PPO-predominant practices were less likely to be high-frequency prescribers of leukotriene inhibitors. However, these physician characteristics were not associated with patient-reported outcomes of health status or quality of life. In contrast, patient sociodemographic factors were associated with the same outcomes.
There has been
Acknowledgements
The authors thank Stephen Shiboski, PhD, for his input and review of the statistical modeling used in this analysis.
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Supported by grants from the National Institutes of Health (HL56438 and HL04201), Bethesda, Maryland, and the National Institute for Occupational Safety and Health (OH03480), Centers for Disease Control and Prevention, Atlanta, Georgia.