Practice of spirometry among physicians caring for children with asthma in Portugal – The EspiroPed survey

Abstract

Aims: to evaluate and compare current knowledge and practice in spirometry(SPR) prescription and interpretation among 4 physician groups caring for children/adolescents with asthma in Portugal: pediatricians(Ped), pulmonologists(Pn), allergy and immunology doctors(AI) and general practitioners(GP).

Methods: Electronic survey sent to members of the 4 national societies. Only completed surveys from doctors following asthmatic children/adolescents were considered. Survey items addressed knowledge, accessibility, practices, interpretation and limitations regarding SPR. Survey Monkey® platform was used, with modified Dillman's technique and anonymized data. Descriptive and comparative analysis was done (χ2 test). A local ethics committee gave approval.

Results: Data from 423 doctors (89Ped, 40Pn, 30AI and 364GP) was analysed; 4% referred training in Pediatric Respiratory Medicine. 30%Ped, 90%Pn, 93%AI and 19%GP knew about SPR ATS/ERS guidelines (p<0.001); with no differences among groups in knowledge of national asthma guidelines. Regarding SPR execution/interpretation, 7%/10%Ped, 53%/65%Pn, 37%/70%AI and 3%/5%GP referred having very good knowledge of these items (p<0.001/p<0.001). As to using SPR in asthma diagnosis/severity stratification, 42%/43%Ped, 75%/68%Pn, 80%/68%AI and 53%/28%GP reported its use (p=0.001/p<0.001). 19%Ped, 25%Pn, 50%AI and 23%GP agreed that SPR results influence therapeutic decisions (p=0.003). Were interested in further training >60%Pn and >85%Ped/AI/GP.

Conclusions: Ped/GP report less familiarity with SPR in asthmatic children than Pn/AI. Acknowledging these gaps will allow implementation of specific SPR dissemination strategies adjusted to each specialty.