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  • Title: Barriers to use of oral rehydration therapy.
    Author: Reis EC, Goepp JG, Katz S, Santosham M.
    Journal: Pediatrics; 1994 May; 93(5):708-11. PubMed ID: 8165066.
    Abstract:
    OBJECTIVE: To identify potential barriers to the use of oral rehydration therapy (ORT) by pediatric practitioners. DESIGN: Cross-sectional, anonymous, self-administered survey of physicians' ORT knowledge, attitudes, and practice. SETTING: A national continuing medical education conference. PARTICIPANTS: One hundred four general pediatricians primarily in private practice (66%) who completed training after 1980 (76%). MEASUREMENTS AND RESULTS: Most 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. CONCLUSION: Efforts to improve use of ORT should be expanded beyond physician education and focus on such barriers as support staff limitations and financial constraints.
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