Knowledge, attitude and practice survey on asthma amongst physicians of 5 countries from Asia and Middle-east-North-Africa

Abstract

This physicians’ (PHYs) survey aimed to understand the real-life clinical management and their challenges while managing their asthma patients (pts) in Nepal, Myanmar, Malaysia, Lebanon and Morocco. Internal medicine doctors (209), general practitioners (206), chest physicians (152) and pediatricians (58) from 232 locations across 5 countries who routinely treat asthma pts were administered a questionnaire-based survey. Data related to their practice and clinical challenges were collected. Of 816 PHY, 374 PHYs treated at least 5 asthma pts daily. 38% PHYs routinely used spirometry for diagnosis; only 12% PHYs routinely recommended peak flow meter for home-monitoring. Fluticasone (58% PHYs), budesonide (46% PHYs) were most preferred ICS. Salmeterol/fluticasone (71% PHYs), formoterol/budesonide (38% PHYs) were most preferred ICS/LABA. 60% PHYs cited nearly 40% of their pts were apprehensive to use inhalers. 72% of PHYs preferred a pMDI to a DPI with only a third of them using a spacer with the pMDI. 71% PHYs believed that using the same device for controller and reliever may be beneficial to patients. Skipping medicines in absence of symptoms (64% PHYs), incorrect inhaler technique (49% PHYs) and high cost of medication (49% PHYs) were considered as major reasons for non-adherence by most PHYs. Incorrect inhaler technique (66% PHYs) and nonadherence (59% PHYs) were considered the most common causes of poor asthma control. There are opportunities to improve the use of diagnostic and monitoring tools for asthma. Nonadherence, incorrect inhaler technique and cost remain a challenge to achieve good asthma control.