Allergen immunotherapy at university health services and allergist's reasons for guidelines nonadherence
Background: Our previous pilot study conducted at the University of Michigan Health Services showed that fewer than 25% of the non-university allergen immunotherapy (AIT) prescribers adhered to AIT labeling guidelines which impacted both patients and healthcare personnel involved in AIT administrati...
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| Veröffentlicht in: | Allergy and asthma proceedings 2017-03, Vol.38 (2), p.115-120 |
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| creator | Karam, Marilyn Holland, Christine Yang, Zi Samuels, Kiela Sanders, Georgiana |
| description | Background: Our previous pilot study conducted at the University of Michigan Health Services showed that fewer than 25% of the non-university allergen immunotherapy (AIT) prescribers adhered to AIT labeling guidelines which impacted both patients and healthcare personnel
involved in AIT administration. Objectives: We expand our study to characterize AIT labeling compliance and impact of practice variability at the "Big 10" University Health Services, and investigate prescribers motives for nonadherence to practice parameter
guidelines. Methods: Three online surveys were distributed: AIT Administrator and Manager surveys for healthcare personnel at the "Big 10"; University Health Services and Physician Survey for physician members of the AAAAI. Data were analyzed using frequency/bivariate
analysis and logistic regression. Results: 21 AIT administrators from 10 University Health Services responded. 90.4% (20/21) felt labels containing all recommended practice parameter guidelines, components would decrease error; and standardization of labels, buildup and
missed dose schedules would increase workflow efficiency (76%; 16/21). 90% (17/19) felt standardized protocols for treatment of systemic reactions would increase patient safety, workflow efficiency and comfort level of administrators. Only 28.6% of AIT extract vial labels at University Health
Services were in accordance with practice parameter guidelines. Despite familiarity with the guidelines (91.5%; 697/762), only 64% (488/762) of surveyed physicians had practice parameter adherent AIT extracts labels with higher odds of a complete label when physicians were in group practice
(odds ratio 1.51; [95% confidence interval, 1.06-2.15]; P=0.02). Reasons for nonadherence included having personalized labeling systems (55.4%, 174/314), unfamiliarity (14%, 44/314) and disagreement (9%, 29/314) with practice parameter guidelines. Conclusion: Poor
adherence with AIT practice parameters labeling guidelines is an important concern in nonallergy offices. It is imperative that allergists comply with the highest recommended standards to provide the best clinical outcomes and ensure excellent and efficient care in both allergy and non-allergy offices. |
| doi_str_mv | 10.2500/aap.2017.38.4017 |
| format | Article |
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involved in AIT administration. Objectives: We expand our study to characterize AIT labeling compliance and impact of practice variability at the "Big 10" University Health Services, and investigate prescribers motives for nonadherence to practice parameter
guidelines. Methods: Three online surveys were distributed: AIT Administrator and Manager surveys for healthcare personnel at the "Big 10"; University Health Services and Physician Survey for physician members of the AAAAI. Data were analyzed using frequency/bivariate
analysis and logistic regression. Results: 21 AIT administrators from 10 University Health Services responded. 90.4% (20/21) felt labels containing all recommended practice parameter guidelines, components would decrease error; and standardization of labels, buildup and
missed dose schedules would increase workflow efficiency (76%; 16/21). 90% (17/19) felt standardized protocols for treatment of systemic reactions would increase patient safety, workflow efficiency and comfort level of administrators. Only 28.6% of AIT extract vial labels at University Health
Services were in accordance with practice parameter guidelines. Despite familiarity with the guidelines (91.5%; 697/762), only 64% (488/762) of surveyed physicians had practice parameter adherent AIT extracts labels with higher odds of a complete label when physicians were in group practice
(odds ratio 1.51; [95% confidence interval, 1.06-2.15]; P=0.02). Reasons for nonadherence included having personalized labeling systems (55.4%, 174/314), unfamiliarity (14%, 44/314) and disagreement (9%, 29/314) with practice parameter guidelines. Conclusion: Poor
adherence with AIT practice parameters labeling guidelines is an important concern in nonallergy offices. It is imperative that allergists comply with the highest recommended standards to provide the best clinical outcomes and ensure excellent and efficient care in both allergy and non-allergy offices.</description><identifier>ISSN: 1088-5412</identifier><identifier>EISSN: 1539-6304</identifier><identifier>DOI: 10.2500/aap.2017.38.4017</identifier><identifier>PMID: 28234048</identifier><language>eng</language><publisher>United States: OceanSide Publications, Inc</publisher><subject>Adherence ; Allergen Extracts ; Allergen Immunotherapy ; Allergists - statistics & numerical data ; Attitude of Health Personnel ; Clinical Competence ; Desensitization, Immunologic - standards ; Guideline Adherence - statistics & numerical data ; Health Services Research ; Humans ; Logistic Models ; Physician Adherence ; Practice Guidelines as Topic ; Practice Parameters ; Practice Parameters Guidelines ; Practice Patterns, Physicians' - statistics & numerical data ; Student Health Services ; Surveys and Questionnaires ; Workflow</subject><ispartof>Allergy and asthma proceedings, 2017-03, Vol.38 (2), p.115-120</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-2782a06bc9b486f69e140f67b8c4afe3fc67c94ae5229a79d42a431fef5e75bd3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28234048$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karam, Marilyn</creatorcontrib><creatorcontrib>Holland, Christine</creatorcontrib><creatorcontrib>Yang, Zi</creatorcontrib><creatorcontrib>Samuels, Kiela</creatorcontrib><creatorcontrib>Sanders, Georgiana</creatorcontrib><title>Allergen immunotherapy at university health services and allergist's reasons for guidelines nonadherence</title><title>Allergy and asthma proceedings</title><addtitle>Allergy Asthma Proc</addtitle><description>Background: Our previous pilot study conducted at the University of Michigan Health Services showed that fewer than 25% of the non-university allergen immunotherapy (AIT) prescribers adhered to AIT labeling guidelines which impacted both patients and healthcare personnel
involved in AIT administration. Objectives: We expand our study to characterize AIT labeling compliance and impact of practice variability at the "Big 10" University Health Services, and investigate prescribers motives for nonadherence to practice parameter
guidelines. Methods: Three online surveys were distributed: AIT Administrator and Manager surveys for healthcare personnel at the "Big 10"; University Health Services and Physician Survey for physician members of the AAAAI. Data were analyzed using frequency/bivariate
analysis and logistic regression. Results: 21 AIT administrators from 10 University Health Services responded. 90.4% (20/21) felt labels containing all recommended practice parameter guidelines, components would decrease error; and standardization of labels, buildup and
missed dose schedules would increase workflow efficiency (76%; 16/21). 90% (17/19) felt standardized protocols for treatment of systemic reactions would increase patient safety, workflow efficiency and comfort level of administrators. Only 28.6% of AIT extract vial labels at University Health
Services were in accordance with practice parameter guidelines. Despite familiarity with the guidelines (91.5%; 697/762), only 64% (488/762) of surveyed physicians had practice parameter adherent AIT extracts labels with higher odds of a complete label when physicians were in group practice
(odds ratio 1.51; [95% confidence interval, 1.06-2.15]; P=0.02). Reasons for nonadherence included having personalized labeling systems (55.4%, 174/314), unfamiliarity (14%, 44/314) and disagreement (9%, 29/314) with practice parameter guidelines. Conclusion: Poor
adherence with AIT practice parameters labeling guidelines is an important concern in nonallergy offices. It is imperative that allergists comply with the highest recommended standards to provide the best clinical outcomes and ensure excellent and efficient care in both allergy and non-allergy offices.</description><subject>Adherence</subject><subject>Allergen Extracts</subject><subject>Allergen Immunotherapy</subject><subject>Allergists - statistics & numerical data</subject><subject>Attitude of Health Personnel</subject><subject>Clinical Competence</subject><subject>Desensitization, Immunologic - standards</subject><subject>Guideline Adherence - statistics & numerical data</subject><subject>Health Services Research</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Physician Adherence</subject><subject>Practice Guidelines as Topic</subject><subject>Practice Parameters</subject><subject>Practice Parameters Guidelines</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Student Health Services</subject><subject>Surveys and Questionnaires</subject><subject>Workflow</subject><issn>1088-5412</issn><issn>1539-6304</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkUuP1DAQhCMEYh9w54R8g0sGv2I7x9FqeUgrwQHOVsfpzHiVcQbbGWn21-Nslr0h4Uu1rOpPraqqesfohjeUfgI4bjhleiPMRhZ9UV2yRrS1ElS-LDM1pm4k4xfVVUr3lDIplHpdXXDDhaTSXFb77Thi3GEg_nCYw5T3GOF4JpDJHPwJY_L5TPYIY96ThPHkHSYCoSfwuOhT_pBIREhTSGSYItnNvsfRh2ILU4C-ADE4fFO9GmBM-PZJr6tfn29_3nyt775_-XazvaudVCLXXBsOVHWu7aRRg2qRSToo3RknYUAxOKVdKwEbzlvQbS85SMEGHBrUTdeL6-rjyj3G6feMKduDTw7HEQJOc7LMGKZlK5n6D6vmjW61aYuVrlYXp5QiDvYY_QHi2TJqlypsqcIuVVhh7FJFWXn_RJ-7A_bPC3-zL4Yfq8GHkn8Gez_NMZRsrHd2cgjBLgUu_dmTMIEXPi8_nFrWSGl7HGAes80Q7e7BJkYLcvsP5Mp7PpI-vnLqOlBuIeaihfEHL9O1_A</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Karam, Marilyn</creator><creator>Holland, Christine</creator><creator>Yang, Zi</creator><creator>Samuels, Kiela</creator><creator>Sanders, Georgiana</creator><general>OceanSide Publications, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20170301</creationdate><title>Allergen immunotherapy at university health services and allergist's reasons for guidelines nonadherence</title><author>Karam, Marilyn ; Holland, Christine ; Yang, Zi ; Samuels, Kiela ; Sanders, Georgiana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c463t-2782a06bc9b486f69e140f67b8c4afe3fc67c94ae5229a79d42a431fef5e75bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adherence</topic><topic>Allergen Extracts</topic><topic>Allergen Immunotherapy</topic><topic>Allergists - statistics & numerical data</topic><topic>Attitude of Health Personnel</topic><topic>Clinical Competence</topic><topic>Desensitization, Immunologic - standards</topic><topic>Guideline Adherence - statistics & numerical data</topic><topic>Health Services Research</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Physician Adherence</topic><topic>Practice Guidelines as Topic</topic><topic>Practice Parameters</topic><topic>Practice Parameters Guidelines</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Student Health Services</topic><topic>Surveys and Questionnaires</topic><topic>Workflow</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karam, Marilyn</creatorcontrib><creatorcontrib>Holland, Christine</creatorcontrib><creatorcontrib>Yang, Zi</creatorcontrib><creatorcontrib>Samuels, Kiela</creatorcontrib><creatorcontrib>Sanders, Georgiana</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Allergy and asthma proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karam, Marilyn</au><au>Holland, Christine</au><au>Yang, Zi</au><au>Samuels, Kiela</au><au>Sanders, Georgiana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Allergen immunotherapy at university health services and allergist's reasons for guidelines nonadherence</atitle><jtitle>Allergy and asthma proceedings</jtitle><addtitle>Allergy Asthma Proc</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>38</volume><issue>2</issue><spage>115</spage><epage>120</epage><pages>115-120</pages><issn>1088-5412</issn><eissn>1539-6304</eissn><abstract>Background: Our previous pilot study conducted at the University of Michigan Health Services showed that fewer than 25% of the non-university allergen immunotherapy (AIT) prescribers adhered to AIT labeling guidelines which impacted both patients and healthcare personnel
involved in AIT administration. Objectives: We expand our study to characterize AIT labeling compliance and impact of practice variability at the "Big 10" University Health Services, and investigate prescribers motives for nonadherence to practice parameter
guidelines. Methods: Three online surveys were distributed: AIT Administrator and Manager surveys for healthcare personnel at the "Big 10"; University Health Services and Physician Survey for physician members of the AAAAI. Data were analyzed using frequency/bivariate
analysis and logistic regression. Results: 21 AIT administrators from 10 University Health Services responded. 90.4% (20/21) felt labels containing all recommended practice parameter guidelines, components would decrease error; and standardization of labels, buildup and
missed dose schedules would increase workflow efficiency (76%; 16/21). 90% (17/19) felt standardized protocols for treatment of systemic reactions would increase patient safety, workflow efficiency and comfort level of administrators. Only 28.6% of AIT extract vial labels at University Health
Services were in accordance with practice parameter guidelines. Despite familiarity with the guidelines (91.5%; 697/762), only 64% (488/762) of surveyed physicians had practice parameter adherent AIT extracts labels with higher odds of a complete label when physicians were in group practice
(odds ratio 1.51; [95% confidence interval, 1.06-2.15]; P=0.02). Reasons for nonadherence included having personalized labeling systems (55.4%, 174/314), unfamiliarity (14%, 44/314) and disagreement (9%, 29/314) with practice parameter guidelines. Conclusion: Poor
adherence with AIT practice parameters labeling guidelines is an important concern in nonallergy offices. It is imperative that allergists comply with the highest recommended standards to provide the best clinical outcomes and ensure excellent and efficient care in both allergy and non-allergy offices.</abstract><cop>United States</cop><pub>OceanSide Publications, Inc</pub><pmid>28234048</pmid><doi>10.2500/aap.2017.38.4017</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adherence Allergen Extracts Allergen Immunotherapy Allergists - statistics & numerical data Attitude of Health Personnel Clinical Competence Desensitization, Immunologic - standards Guideline Adherence - statistics & numerical data Health Services Research Humans Logistic Models Physician Adherence Practice Guidelines as Topic Practice Parameters Practice Parameters Guidelines Practice Patterns, Physicians' - statistics & numerical data Student Health Services Surveys and Questionnaires Workflow |
| title | Allergen immunotherapy at university health services and allergist's reasons for guidelines nonadherence |
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