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Have expert guidelines made a difference in asthma outcomes?

Podjasek, Jenna C.; Rank, Matthew A.

Current Opinion in Allergy and Clinical Immunology: June 2013 - Volume 13 - Issue 3 - p 237–243
doi: 10.1097/ACI.0b013e32836093c3
OUTCOME MEASURES: Edited by Henry Milgrom and Ralph Mösges

Purpose of review To analyze and summarize research from 2011 to 2012 that examines the relationship of guideline implementation and asthma outcomes.

Recent findings Evidence of an unmet need for better asthma management was reported in two large survey studies from the US and Europe. Interventional studies of guideline implementation were often limited by lack of uptake of the intervention (i.e. educational program, computer-assisted assessment). Even studies in which there was uptake to the intervention, asthma outcomes often did not improve. Certain interventions (specific electronic asthma management tools, provider education workshops, community-wide interventional programs, and parental educational programs) were associated with improved asthma outcomes. Observational studies, likewise, revealed that evidence of guideline implementation did not necessarily translate into improved asthma outcomes.

Summary Asthma guideline implementation studies are frequently associated with a limited impact on asthma outcomes. Understanding the gaps between guideline recommendations and translation to clinical practice remains an important opportunity to improve asthma outcomes.

aDivision of Allergic Diseases, Mayo Clinic, Rochester, Minnesota

bDivision of Allergy, Asthma and Clinical Immunology, Mayo Clinic, Scottsdale, Arizona, USA

Correspondence to Matthew A. Rank, MD, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA. Tel: +1 480 301 4284; e-mail:

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