Asthma knowledge, attitude and prescribing behavior of primary health care physicians in the Kingdom of Bahrain

Abstract

Background: Asthma is a serious public health problem, affecting people of all ages. When uncontrolled it can cause significant morbidity and mortality. Poor implementation of the guidelines is considered one of several barriers for achieving asthma control. Objectives: To determine the asthma knowledge, attitude and prescribing behavior of primary health care physicians in the Kingdom of Bahrain. Methods: A cross–sectional survey was carried out from March 2012 to March 2013 among primary health care physicians (PHC) attending asthma workshops as part of a continuing medical education program. During the study period 5 workshops were conducted which were attended by PHC physicians. A self-administered questionnaire was designed to achieve the research objective. The questionnaire was based primarily on a previous study carried out by the Chicago Asthma Surveillance Initiative (CASI) in the USA; a similar questionnaire was used in a study conducted in 2004, and permission was taken from the investigators to use it in our study. Questionnaires were distributed to the study groups at the beginning of each workshop and 192 of the 240 attending doctors completed the questionnaire, an 80% response rate. Results: The responders were mainly family physicians (66.7%), of whom 73.4% were following asthma guidelines. The study showed that slightly more than half of PHC physicians (56.8%) were able to assess the level of asthma control appropriately and the majority of them reported scheduling regular follow-ups for their patients. However, only 39.1% of PHC physicians were aware of the appropriate medication recommended for step 1 and only 37.3% of them reported that they provided written plans for their patients. Conclusion: Various aspects of GINA guidelines appear to have been integrated into clinical practice by primary care physicians in the Kingdom of Bahrain, whereas other recommendations do not seem to have been readily implemented.