• E C Reis, J G Goepp, S Katz, and M Santosham.
• Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
• Pediatrics. 1994 May 1;93(5):708-11.

ObjectiveTo identify potential barriers to the use of oral rehydration therapy (ORT) by pediatric practitioners.DesignCross-sectional, anonymous, self-administered survey of physicians' ORT knowledge, attitudes, and practice.SettingA national continuing medical education conference.ParticipantsOne hundred four general pediatricians primarily in private practice (66%) who completed training after 1980 (76%).Measurements And ResultsMost respondents (83%) reported that ORT plays an important role in their management of dehydration. However, compliance with guidelines from the American Academy of Pediatrics for use of oral therapy is limited: 30% withhold ORT in children with vomiting or moderate dehydration, 50% fail to advise prompt refeeding, and only 3% advise use of a spoon or syringe. The degree of importance of ORT in physicians' practice was negatively associated with reported lack of convenience of ORT administration in the practice setting (P < .001), support staff preference for intravenous versus ORT (P < .001), need for additional training of support staff to implement ORT (P < .01), and likelihood of reimbursement for intravenous versus ORT (P = .07). Notably, degree of importance of ORT was not associated with physician ORT knowledge.ConclusionEfforts to improve use of ORT should be expanded beyond physician education and focus on such barriers as support staff limitations and financial constraints.

22 keywords...

hide…