How far are we from adhering to national asthma guidelines: The awareness factor

AbstractBackgroundThe Saudi national asthma protocol (SNAP) for asthma management was released in 1995 in an attempt to streamline asthma management practices in Saudi Arabia and improve the quality of care for asthma. Up to our knowledge, few studies assessed the adherence of Saudi physicians to the national asthma guidelines.ObjectivesThe objective of this present study was to assess the level of adherence of pediatricians and primary care physicians (PCPs) to the current SNAP recommendations and identify barriers to physician adherence.MethodologyThis is a cross-sectional study involving pediatricians and PCPs selected randomly from five major governmental hospitals in Riyadh, Saudi Arabia. Subjects were administered a self-administered questionnaire comprising 24 questions assessing their awareness of SNAP and their level of adherence to the recommendations.ResultsThe response rate was 38% (80/206). Out of most of the physicians who responded, 70% (56) were aware of SNAP, and only 78.2% (n=43) of them had modified their management of asthmatic patients according to the SNAP recommendations. The level of knowledge of the pharmacotherapy and diagnostic parts of the guidelines ranged between 41.5% and 90.7% in the pharmacotherapy part, and 53.7–59.6% in the diagnostic part. The most common barriers to adherence to SNAP were lack of awareness (25.2%), patient non- compliance (18.9%) and lack of resources (13.5%). There was no significant difference in awareness between pediatricians and PCPs (69.2%, 70.7% respectively).ConclusionThis study reveals a substantial gap between the actual care provided by pediatricians and PCPs to asthmatic patients and the recommendations formulated in the Saudi National Asthma Protocol (SNAP). Lack of awareness remains the most common barrier for adherence to the guidelines followed by patient non-compliance. To improve SNAP guideline adherence, tailored interventions that address barriers to adherence need to be implemented