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Do Doctors Adhere to Asthma Management Guidelines?

A recent article published in BMC Pulmonary Medicine surveys physicians to understand their views on the new guidelines for asthma management.

Asthma is a widespread, global health problem that impairs the quality of life and workplace productivity for many. There have been advances in asthma treatments, but many patients still cannot effectively manage their disease. There are many national guidelines to optimize and improve the management of asthma, and they are constantly updated as new research and treatments are available. Studies have shown, however, that there are striking differences in how patients and physicians view the patient’s asthma education, treatment adherence, and level of asthma control. There lacks a focus on physicians’ perspectives on asthma control and therefore studies are required to better understand asthma management practices from the view of physicians.

The Global Asthma Physician Survey

An American group recently published a study in BMC Pulmonary Medicine delving into the perspectives of the physicians who treat asthma. This large global study, named GAPS (Global Asthma Physician Survey), aimed to add to the knowledge of asthma management by assessing the physician’s perspectives regarding the burden, management, and treatment of asthma. This study surveyed 1,809 physicians from Australia, Canada, China, France, Germany, and Japan on various aspects of asthma management.

Do Physicians Treat Asthma According to Guidelines?

The results showed that 83% of the physicians surveyed believed that the health outlook for patients has improved over the past ten years due to increased treatment options or improved medications. Additionally, 87% of the physicians reported that they monitored patient adherence to the treatments, mostly through direct patient interactions. Notably, the way those physicians assess asthma control varied greatly among different countries. For example, Chinese physicians monitored symptom frequency, but Japanese physicians monitored exacerbations.

One common reason for why physicians believed patients didn’t receive the best treatment was that “patients failed to understand the importance of using the medication.” Lastly, few physicians frequently used a newer strategy called single maintenance and reliever therapy (MART), which is recommended in new guidelines, to treat asthma and instead followed older guidelines.

The study demonstrated large variations in asthma management practices among the countries, but there were significant similarities as well. The majority of physicians believe that asthma management is improving, but that patients lack understanding of the disease and treatment to fully take advantage of the effectiveness of asthma medications. Moreover, physicians tended to stick to older guidelines and did not implement the use of MART. Altogether, the results of this study show a need for better patient and physician education on treatments and guidelines globally in order to improve asthma outcomes.

Written by Branson Chen, BHSc

Reference: Chapman KR, Hinds D, Piazza P, Raherison C, Gibbs M, Greulich T, Gaalswyk K, Lin J, Adachi M, Davis KJ. Physician perspectives on the burden and management of asthma in six countries: The Global Asthma Physician Survey (GAPS). BMC Pulmonary Medicine. 2017 Dec;17(1):153.

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