Guideline-based medicine grading on the basis of the guidelines of care for ambulatory atopic dermatitis treatment in the United States.
J Am Acad Dermatol
; 80(2): 417-424, 2019 Feb.
Article
em En
| MEDLINE
| ID: mdl-30287314
ABSTRACT
PURPOSE:
This study was designed to assess the adherence to evidence-based guidelines of care for atopic dermatitis (AD).METHODS:
To characterize AD treatment in the United States, ambulatory visits from the 2006-2015 National Ambulatory Medical Care Survey were analyzed. For each medication prescribed, a grade was assigned on the basis of the American Academy of Dermatology treatment guidelines for topical and systemic medications. Considering all visit prescriptions, I calculated a composite grade, analogous to the US academic grading system (scores A-F).RESULTS:
I noted prescribing differences across specialty groups. Systemic corticosteroids were more likely to be prescribed by family and general physicians and less likely by pediatricians. Dermatologists were more likely than other specialties to prescribe nonsedating antihistamines, which lack a guideline base supporting their use. Depending upon modeling of care assumptions, all physician specialty visits earned mean guideline-based grades of B or C in their care of AD patients.LIMITATIONS:
The clinical, social, and demographic factors influencing prescribing behavior cannot be completely assessed by using extant data.CONCLUSIONS:
This preliminary study demonstrates that physicians might benefit from reviewing guidelines of care; there might be an educational gap in the implementation of these guidelines.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Guias de Prática Clínica como Assunto
/
Fidelidade a Diretrizes
/
Dermatite Atópica
/
Fármacos Dermatológicos
/
Assistência Ambulatorial
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article