Use of point-of-care resources for management of paediatric asthma: frequency, types and temporal trends in early-career general practitioners

初级全科医生利用床旁资源管理儿童哮喘的频率、类型和时间趋势

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Abstract

OBJECTIVE: To investigate the frequency and temporal trends in Australian early-career general practitioners (registrars) accessing point-of-care resources (POCR) when managing paediatric asthma. DESIGN: A longitudinal analysis (2010-2019) nested within the Registrar Clinical Encounters in Training project of registrars' in-consultation practice. The outcome factor in univariable and multivariable mixed effects logistic regression analyses was whether POCR was accessed for paediatric asthma problems, with year as the independent variable of interest. Further analyses compared trends (2010-2019) in asthma problem POCR use with non-asthma problem POCR use. SETTING: Australian community training general practices. PARTICIPANTS: 2834 Australian general practice registrars (trainees) (participation rate 92.2%). RESULT: POCR use was greater for asthma (15%) than for non-asthma problems (12.6%). The temporal increase in POCR use for paediatric asthma (OR for POCR use 1.15 per year (95% CI 1.07 to 1.24)) was greater than that for non-asthma problems (OR of 1.11 per year (95% CI 1.09 to 1.14)). This difference in rates of increase in POCR of paediatric asthma and non-asthma problems was not statistically significant. CONCLUSION: There are multiple possible reasons for the increasing use of POCR in paediatric asthma. This trend may reflect increasing focus on evidence-based asthma care and increasing access to high-quality asthma management online POCR available within Australia. Alternatively, paediatric asthma could represent an area of increasing clinical challenge and possible educational need for early-career general practitioners. Further research exploring the underlying reasons for the increasing POCR use in paediatric asthma is warranted.

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