Knowledge of asthma management by general practitioners in Karachi, Pakistan: comparison with international guidelines

Bhulani, Nizar; Lalani, Saima; Ahmed, Aliya; Jan, Yahya; Faheem, Urooba; Khan, Ayub; Samani, Zahra Aziz; Aman, Wahaj; Bhatti, Faria; Hayat, Omar; Saleem, Sarah

doi:10.4104/pcrj.2011.00096

Cited by 13 publications

(12 citation statements)

References 2 publications

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“… 34 In addition, the number of PCPs who had adequate knowledge practice in asthma management in a study in Pakistan is very low as 10.4%. 36 With asthma treatment in general (both starting and adjustment), the percentage of physicians who achieved ≥50% of correct answers (≥5/9) for all nine questions on treatment in our study is 22% ( Figure 1B ); this is roughly similar to that in the same format study in Hong Kong (32%). 28…”

Section: Discussionsupporting

confidence: 79%

Implementation of GINA guidelines in asthma management by primary care physicians in Vietnam

Nguyen

et al. 2017

IJGM

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BackgroundAsthma control is suboptimal in Vietnam. Lack of knowledge of primary care physicians (PCPs) for asthma management may potentially be one of the causes.PurposeThe aim of this study was to assess the knowledge and practice of PCPs’ asthma management based on the Global Initiative for Asthma (GINA) guidelines (2015 update).MethodsA cross-sectional study with convenience sampling was conducted among PCPs in an urban and rural area of Vietnam using questionnaires related to asthma patients daily practice: use of spirometry and the asthma control test (ACT), prescription of asthma medications, and frequency of consultations. Five asthma case scenarios were also used to ask participants to classify GINA-defined levels of asthma control and to choose the initial or adjusted treatment options based on the current situation. All scenarios are common in Vietnam, ie, three cases for adults, one case for children, and one case for pregnant women.ResultsOf the 327 completed questionnaires, 201 questionnaires could be analyzed. Most PCPs consulted their asthma patients on a weekly to monthly basis. Approximately 50% used spirometry for asthma care and only 25% used ACT. For asthma treatment, oral short-acting beta agonists and oral steroids were still commonly used and long-acting beta agonists alone were prescribed by 70%. Regarding GINA-defined levels of asthma control, 24% of the responders had ≥50% of correct answers, 21% had no correct answers, 2% had all five correct answers, and 20–42% had a correct answer for each of the five questions. Regarding treatment choice, 22% had ≥50% of correct answers, 14% had a wrong answer for all nine questions, and no respondent had a correct answer for ≥8 questions.ConclusionThe percentage of PCPs in Vietnam who had implemented GINA 2015 was low. Some drugs with a high risk of side effects were still being prescribed. There is a need to improve both knowledge and daily practice. Additional studies should determine why these guidelines are not largely adopted by PCPs in Vietnam.

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Section: Discussionsupporting

confidence: 79%

Implementation of GINA guidelines in asthma management by primary care physicians in Vietnam

Nguyen

et al. 2017

IJGM

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“…Another reason could be failure by clinicians to prescribe MDIs due to concerns about their intermittent availability and prohibitive cost to patients [ 31 ]. Conversely, clinicians in the developing world may lack the knowledge on what medications to use for asthma treatment, commonly prescribing oral SABA and oral steroid for long-term management [ 32 , 33 ]. Ultimately, even when physicians do prescribe inhaled medications, some patients may just prefer the oral route due to various negative preconceived ideas about MDIs [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Knowledge and perceptions of asthma in Zambia: a cross-sectional survey

Marsden¹,

Somwe

Chabala

et al. 2016

BMC Pulm Med

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BackgroundZambia is currently experiencing an epidemiological transition, from communicable to non-communicable diseases. The annual rate of physician-diagnosed asthma is estimated at 3 %. However, the general public’s knowledge of asthma symptoms and signs, and their perception of asthma remain unknown. A survey was conducted aiming to determine knowledge and perceptions of asthma among Zambians.MethodsAdults and adolescents attending four clinics in the capital, Lusaka, were surveyed using a standardized questionnaire from July 2011 to March 2012.ResultsData from 1,540 participants (mean age 30.7 years, 65 % female) were collected. Most patients (74 %) were living in low-cost housing. One hundred and sixteen (7.6 %) participants reported either a medical diagnosis of asthma or currently taking asthma medications. The most frequent asthma symptoms reported were wheezing (88 %), and waking up at night with either shortness of breath (85 %), chest tightness (85 %), or cough (67 %). Medications used to treat asthma were mostly oral short-acting beta-agonists (SABA) (59 %), inhaled SABA (30.2 %) and antibiotics (29.8 %). Inhaled steroids were only used by 16.4 % while less than 1 % were on long-acting beta-agonists (LABA). Many misconceptions were identified among the entire surveyed population with only 54.7 % believing hospitalisations are not preventable, 54.7 % believing asthma symptoms can be prevented with the right medications and 37 % believing inhalers are addictive. Nearly 60 % thought that people with asthma cannot exercise or play hard. Significantly more individuals with asthma compared to those without thought tablets are better than inhalers for the treatment of asthma (46 % vs 30 %).ConclusionsWe conclude that knowledge on asthma is poor in Zambia, where there remains many misconceptions on asthma and its management.

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“…Cigarette smoking is known to reduce the efficacy of ICS [19]. Taken together, we speculate that these differences were related to inappropriate education and insufficient clinical skills by GP [8,10,11,20].…”

Section: Discussionmentioning

confidence: 85%

“…Unfortunately, not all GPs adhere to these guidelines [8]. In fact, evidence suggests under-treatment of asthmatics by Japanese physicians [9], and some studies have reported that GPs lag behind RS with regard to the management of asthma [8,10,11].…”

Section: Introductionmentioning

confidence: 99%

Comparison of clinical management of young and elderly asthmatics by respiratory specialists and general practitioners

Tada¹,

Kuraki²,

Taooka³

et al. 2014

Journal of Asthma

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Knowledge of asthma management by general practitioners in Karachi, Pakistan: comparison with international guidelines

Abstract: Background: Suboptimal management of asthma by general practitioners (GPs) can lead to poor health outcomes

Cited by 13 publications

References 2 publications

Implementation of GINA guidelines in asthma management by primary care physicians in Vietnam

Implementation of GINA guidelines in asthma management by primary care physicians in Vietnam

Knowledge and perceptions of asthma in Zambia: a cross-sectional survey

Comparison of clinical management of young and elderly asthmatics by respiratory specialists and general practitioners

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