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Many Pediatric Primary Care Doctors Don't Use Spirometry

In survey of family physicians and pediatricians with young asthma patients, about half used spirometry

FRIDAY, Sept. 10 (HealthDay News) -- Spirometry use is limited among pediatric primary care physicians, particularly pediatricians, suggesting a need for additional physician training, according to research published online Sept. 6 in Pediatrics.

Kevin J. Dombkowski, of the University of Michigan in Ann Arbor, and colleagues analyzed data from surveys of 360 family physicians and pediatricians who provided care to children with asthma. The survey included a clinical vignette to assess the role of spirometry in physicians' recognition of asthma severity and their medication choices.

The researchers found that roughly half (52 percent) used spirometry in clinical practice, compared to 80 percent who used peak flow meters and 10 percent who did not use lung function tests. Just 21 percent of respondents used spirometry routinely for all guideline-recommended clinical situations. Family physicians were more likely than pediatricians to use spirometry (75 versus 35 percent), and the family physicians were more comfortable interpreting the results (50 versus 25 percent). Just half of the respondents correctly interpreted the spirometric results in the vignette. Two-thirds of the physicians said they would like additional training on implementing spirometry in their practices.

"Our findings suggest that important shortcomings in spirometric testing are commonplace among pediatric primary care providers, especially among pediatricians. This study highlights physician deficiencies in interpreting spirometric results, as well as perceived barriers to incorporating spirometric testing in clinical practice. To realize the potential benefits of spirometric testing among children with asthma, promotion of spirometry training programs will need to be a priority," the authors conclude.

The Blue Cross Blue Shield of Michigan Foundation supported the study.

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