Guessous I, Cornuz J, Stoianov R, Burnand B, Fitting JW, Yersin B, Lamy O
The purpose of this study was to measure and compare the efficacy of two modalities of chest physiotherapy (CP) guideline implementation on the appropriateness of CP prescription among patients hospitalised for community-acquired pneumonia (CAP). The CP prescription rate and duration was measured in all consecutive admitted CAP inpatients during three consecutive one-year time periods: (1) before any guideline implementation; (2) after a passive implementation by medical grand rounds and guideline diffusion through mailing; (3) after adding a one-page reminder in the CAP patient's medical chart highlighting our recommendations.
Both passive and active implementation of guidelines appear to improve the appropriateness of CP prescription among inpatients with CAP without impairing their outcomes. Restricting CP use to patients who benefit from this treatment might be an opportunity to decrease CAP medical cost and workload.
Respiratory Medicine, 2008 Jul 9, online article ahead of print