Evidence map›Paper›PMID 24821894›Full record

Trial reportAnnals of family medicine

Implementing asthma guidelines using practice facilitation and local learning collaboratives: a randomized controlled trial.

James W Mold, Chester Fox, Angela Wisniewski, Paula Darby Lipman, Margot R Krauss, D Robert Harris, Cheryl Aspy, Rachel A Cohen, Kurt Elward, Paul Frame and 3 more

Open access · diamondAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 5 pooled it
15.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 5 syntheses or guidelines pooled it, 72 citations in OpenAlex.

  1. Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025
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  13. A Randomized Trial of High-Value Change Using Practice Facilitation.Journal of the American Board of Family Medicine : JABFM
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 7 institutions in 1 country.

James W MoldUniversity of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Chester Fox
Angela Wisniewski
Paula Darby Lipman
Margot R Krauss
D Robert Harris
Cheryl Aspy
Rachel A Cohen
Kurt Elward
Paul Frame
Barbara P Yawn
Leif I Solberg
René Gonin
Westat (United States) · USUniversity at Buffalo, State University of New York · USUniversity of Oklahoma Health Sciences Center · USHealthPartners · USSUNY Geneseo · USUniversity of Rochester · USUniversity of Virginia · US

Funding

Implementation of Asthma Guidelines in Primary Care; Comparison of 4 approachesR01HL091827 · NHLBI · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI MOLD, JAMES W. · 2009 to 2010
$1.7M
NHLBI NIH HHS HHS-5R01HL091827NHLBI NIH HHS R01 HL091827
6 · The paper itself

Abstract

purposeGuideline implementation in primary care has proven difficult. Although external assistance through performance feedback, academic detailing, practice facilitation (PF), and learning collaboratives seems to help, the best combination of interventions has not been determined.

methodsIn a cluster randomized trial, we compared the independent and combined effectiveness of PF and local learning collaboratives (LLCs), combined with performance feedback and academic detailing, with performance feedback and academic detailing alone on implementation of the National Heart, Lung and Blood Institute's Asthma Guidelines. The study was conducted in 3 primary care practice-based research networks. Medical records of patients with asthma seen during pre- and postintervention periods were abstracted to determine adherence to 6 guideline recommendations. McNemar's test and multivariate modeling were used to evaluate the impact of the interventions.

resultsAcross 43 practices, 1,016 patients met inclusion criteria. Overall, adherence to all 6 recommendations increased (P ≤.002). Examination of improvement by study arm in unadjusted analyses showed that practices in the control arm significantly improved adherence to 2 of 6 recommendations, whereas practices in the PF arm improved in 3, practices in the LLCs improved in 4, and practices in the PF + LLC arm improved in 5 of 6 recommendations. In multivariate modeling, PF practices significantly improved assessment of asthma severity (odds ratio [OR] = 2.5, 95% CI, 1.7-3.8) and assessment of asthma level of control (OR = 2.3, 95% CI, 1.5-3.5) compared with control practices. Practices assigned to LLCs did not improve significantly more than control practices for any recommendation.

conclusionsAddition of PF to performance feedback and academic detailing was helpful to practices attempting to improve adherence to asthma guidelines.

Indexed as

Guideline AdherenceAdultAsthmaChildFeedbackFemaleHumansMalePractice Guidelines as TopicPrimary Health CareSeverity of Illness Indexasthmapractice-based research networkpractice facilitationpractice guidelines as topicprimary health carequality improvement

Identifiers

PMID24821894
PMCPMC4018371
OpenAlexW2138552996

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.