How can we improve the pace at which best practices are implemented?
Through medical history, improved practices are often accepted at a glacial pace. The British Navy adopted citrus fruit to prevent scurvy in 1795, almost 50 years after James Lind's observations were initially circulated. More than two centuries later, barriers to implement better practices still remain. But in this information age, awareness is only part of the problem, and the entire medical community from publishers, to practitioners, to consumers must work to improve adoption.
Pediatric asthma affects close to 5 million children in the United States. In 1997 the National Institutes of Health published practice guidelines to "bridge the gap between current knowledge and practice." Based on numerous studies, the NIH guidelines recommend that physicians prescribe daily-inhaled corticosteroids for children with persistent asthma symptoms.
The guidelines have had limited impact. A national survey found that only 55% of patients ...
