Physician Specialty Influences Tertiary Care Pediatric Asthma Management.

摘要

Physician training influences the care that a patient receives. A retrospective cohort of children over 6 years of age, seen in a multi-disciplinary asthma clinic between 2009 and 2010 and followed to 2012, was completed to identify differences in pediatric asthma management by physician specialty. Multilevel logistic regression analysis examined differences by physician specialty for prescribed inhaled corticosteroids (ICS). Over 56% of the patients were seen by pediatric respirologists, 26% by pediatric allergists and 18% by pediatricians. Differences in investigations by specialty reflected on co-morbid diagnoses and treatment. Pediatricians were less likely to prescribe ICS (OR: 0.39; 95% CI: 0.15 -- 0.96, p<0.05) than pediatric allergists with the greatest difference in ICS prescription among children with a %FEV1 greater than 80%. Treatment with ICS among children with mild asthma is most heavily influenced by physician specialty. The results of this study have implications for asthma management in future asthma practice guidelines.