Abstract :
Background: Chronic diseases represent an increasing burden for health care systems. Ongoing
research efforts provide regularly new scientific evidence on how optimize current medical care. In regard to
respiratory diseases, as for other health problems, optimal management of these conditions has been summarized
in recent consensus guidelines but implementation of these recommendations is still poor. Not only are the keymessages
of such guidelines often unknown to the practitioner and the patient but even when it is, they are often
insufficiently integrated into current care, often related to behavioral, organizational and communication barriers.
Methods: Literature review on the topic of Clinical Practice Guidelines implementation and reference to recent
projects aimed at improving management of asthma in the province of Quebec and elsewhere, as models for such
implementation process. Results: The basic principles of an effective translation of current knowledge into dayto-
day care are known, but healthcare delivery structures, practice tools and resources, and regional/local
leadership should be available to make it happen. Ideally, implementation requires a multidisciplinary effort of
care providers, specialists, general practitioners, allied health professionals, patients and their family. The general
public, health administrators and policy makers should also be aware of the consequences of poor management of
these diseases and be supportive of the proposed initiatives. Finally, these last should be adequately evaluated to
ensure their effectiveness and determine if they should be improved. Recently projects performed in Quebec have
proposed disease management models to identify asthma care gaps and improve translation of current Guidelines
into day-to-day care. Conclusions: Although the human and socio-economical burden of chronic diseases is still
increasing, their current management is still often deficient. In the recent decades, Practice Guidelines have been
developed to guide Practitioners towards optimal care, but implementation of these Guides is still poor. Recent
Canadian and International initiatives have proposed valid models to help address current care gaps
Keywords :
knowledge transfer. , asthma , Care gaps , asthma treatment , Healthcare , Asthma management
