Patient Safety and Quality

Distance-based training in spirometry use increases the quality of asthma diagnosis

Spirometry is a common office test used to diagnose asthma and other conditions affecting breathing by measuring how much air you can inhale and exhale, as well as how fast you can exhale. However, lack of training and feedback for diagnostic spirometry are major barriers to its successful incorporation into primary care for asthma patients. The good news is that online spirometry training can improve the quality of spirometry testing and the assessment of asthma severity at primary care pediatric practices. The researchers developed and evaluated a spirometry training and feedback program that they delivered entirely by distance through the use of a CD-ROM and a series of webinars. The seven practices receiving the intervention had a significantly greater probability of performing acceptable quality spirometry testing sessions than the seven control group practices.

Providers participating in the intervention had a 2.9 times greater probability of documenting asthma severity during the intervention period than the control group. The proportion of asthma patients labeled as having persistent asthma increased from 43 percent to 62 percent among intervention practices, but it declined from 57 to 50 percent among the control practices. The training intervention consisted of two parts: a 70-minute 10-module interactive tutorial on a multimedia CD-ROM, and a series of five hour-long webinars delivered over 7 months to a combination of providers and support staff. The study was supported by the Agency for Healthcare Research and Quality (Contract No. 290-06-00022).

See "Learning from a distance: Effectiveness of online spirometry training in improving asthma care," by James W. Stout, M.D., Karen Smith, M.D., Chuan Zhou, Ph.D., and others in Academic Pediatrics 12, pp. 88-95, 2012.

— MWS