Perception of primary care physicians about guidelines of bronchial asthma

BackgroundAdopting clear guidelines for diagnosis and management of bronchial asthma could improve the medical care services administered to asthmatic patients. This can be reflected on amelioration of manifestations, decrease of attacks of asthma and hence decrease the medical burden of the disease.ObjectivesThe current study was designed to evaluate the adherence of primary health care physicians to the recommendations of the National Protocol for Management of Asthma in Kuwait and the factors affecting this adoption, reveal their knowledge, attitude and practices about bronchial asthma, and identify barriers for caring of asthmatic patients.Subjects and methodsThe target population was primary health care physicians. All the primary health care physicians of two randomly selected health districts, out of five, were included. Out of 376 physicians available during the field period, 250 agreed to share in this study with an overall response rate of 66.5%.ResultsThe results showed that only 37.2% of the studied primary health care physicians were adhering to asthma guidelines. Level of education, Knowledge about asthma, and clinical practice proved to be significant predictors of adherence to asthma guidelines. Although physicians had a high positive attitude toward asthma yet, they have poor knowledge and practice scores. The most common institutional barriers were improper follow up system and lack of spirometers, while heavy workload and lack of training were the main barriers related to health staff. Non compliance of patients to management and follow up schedules were on the top of barriers related to patients.ConclusionPhysicians at the primary health care centers had a low adherence rate to asthma guidelines. Although they had high positive attitude toward asthma yet their knowledge and practice need improvement. To enhance adequate medical care to asthmatics; focus should be concentrated on increasing awareness and task based on job training of physicians as well as providing lung ventilation measuring equipment and improving the follow up system of bronchial asthma.