Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725 Chemin Sainte-Foy, Québec, QC, Canada G1V 4G5. lpboulet@med.ulaval.ca
We describe a new tool, the Physicians' Practice Assessment Questionnaire (PPAQ), designed for the global self-assessment of implementation of asthma and COPD guidelines, as determined by the percentage of patients in whom physicians estimate that they implement guidelines key recommendations. Some of its properties were assessed by a group of 47 general practitioners (GPs), and test-retest data were obtained in repeating the questionnaire at a 5-week interval without intervention in a sub-group of 28 practitioners. Answers to the various questions were globally reproducible. The lowest scores (recommendations implemented in less than 50% of their patients) were: 1) for both asthma and COPD: referral for patient education, provision of a written action plan and regular assessment of inhaler technique, 2) for asthma: referral to a specialist for difficult to control asthma or uncertain diagnosis, and 3) for COPD: assessment of lung function and disability according to specific criteria and referral to a rehabilitation program. The analysis showed sufficient internal consistency for both questionnaires (Cronbach alphas 0.7617 for asthma and 0.8317 for COPD). Pearson's correlations indicated good test-retest (r = 0.6421, p = 0.0002 for asthma; r = 0.6801, p