AHRQ Report Helps Chest Physicians Develop Asthma Treatment Guidelines

The American College of Chest Physicians (ACCP) used findings from AHRQ's Evidence Report No.129, Diagnosis and Management of Work-Related Asthma, to develop a clinical practice guideline as well as a user-friendly clinical resource guide on occupational asthma for physicians and patients.

According to Carla Herrerias, Clinical Research Analyst at ACCP, the College relies heavily on AHRQ's evidence reports, among other resources, to form the basis of many of its clinical guidelines. However, "the development of the occupational asthma guideline," she notes, "was unique in that the [AHRQ] evidence report was the real driving force behind the development of our occupational asthma guideline. In fact, much of the clinical practice guideline was based on the evidence report."

Although the ACCP had previously developed a consensus statement on the broader topic of asthma prior to the release of the evidence report, the organization had yet to develop clinical guidelines specifically focused on occupational asthma.

Subsequent to the release of the AHRQ evidence report, the ACCP organized a guideline development panel, comprised of about 15 methodological and clinical experts, including the lead methodologists from the Alberta Evidence-based Practice Center who authored the evidence report, and other experts from ACCP's airways and occupational and environmental subspecialty network groups.

"The panel found that the methodological rigor of the AHRQ evidence report on occupational asthma met their needs, and they used it as a primary source of data," Herrierias explains. "I think this evidence report worked very, very well. It's difficult when you have to work with reports that don't meet your needs."

ACCP intends to develop a user-friendly version of the guideline in the form of an educational/informational resource on CD-ROM for both patients and physicians and is in the process of implementing a broad dissemination strategy for its new guideline on occupational asthma. It will be posted to ACCP's Web site (http://www.chestnet.org) with a link to the AHRQ evidence report, and it will be submitted to the National Guideline Clearinghouse.

In addition, ACCP intends to publish the guideline in its journal, CHEST, for distribution to its members. ACCP also plans to conduct a major public relations campaign, sending out a press kit and placing a trailer on the ACCP Web site highlighting the availability of the guideline.

ACCP is now in the process of investigating methods to determine how guidelines are being used to affect change in clinical practice and patient behavior, including a survey of the College's membership that will assess a guideline's impact on diagnosis and management practices.

ACCP is the world's largest clinical cardiopulmonary and critical care medical society, with 16,600 members in 100 countries.