Improving quality of care and guideline adherence for asthma through a group self-assessment module

Background: the quality of care for asthma remains suboptimal. compliance with guidelines remains low,but improved adherence to guidelines may increase the quality of care. but. we conducted a trial to determine whether group self-assessment module (sam) activities led by a facilitator and conducted as part of maintenance of certification for family physicians (mc-fp) would increase knowledge of and adherence to asthma guidelines. methods: participating physicians completed audits of the charts of patients with asthma before and 6 months after a group sam. surveys of physicians' knowledge of asthma guidelines were administered immediately before,immediately after,and 6 months after the group sam. we tested for differences in knowledge of and adherence to guidelines before and after the sam using χ2 and t tests. results: thirty-eight physicians in virginia completed the sam and had complete data. participants completed more mc-fp activities than other physicians but were comparable in other characteristics. except for prescribing controller medications for persistent asthma,all other quality measures significantly improved 6 months after the group sam. diagnosis by severity improved from 48.3% to 80.2%,and the use of action plans increased from 8.1% to 54.1%. physicians' knowledge of guidelines improved immediately after the sam and was sustained at 6 months. increased knowledge translated into clinical skills: 30% of participants reported comfort with assessing control after the sam,which increased to 97.5% 6 months after the sam. conclusions: group sams may be an effective method to increase physicians' knowledge of and adherence to clinical guidelines.