Alrabiah Abdulaziz M, Elsaid Tarek, Tourkmani Ayla
Department of Family Medicine, Prince Sultan Military Medical City, Riyadh, KSA.
J Family Med Prim Care. 2018 Sep-Oct;7(5):927-936. doi: 10.4103/jfmpc.jfmpc_189_18.
The level of uncontrolled asthma is still high despite the availability of effective treatments and evidence-based guidelines for controlling asthma. Knowledge and adherence to evidence-based guidelines among care providers are crucial to the treatment.
To investigate the determinants of family physicians' knowledge and application of asthma management guidelines at primary healthcare setting in Saudi Arabia.
This is a cross-sectional study, conducted at 18 primary healthcare centers in Riyadh, Saudi Arabia. The sample consisted of 246 physicians. A self-administrated questionnaire was distributed among the physicians. The questionnaire included demographic, job characteristics, knowledge of asthma guidelines, and application of asthma guidelines' questions about the essential items related to diagnosis and management of asthma according to the international/local guidelines. The minimum acceptable level for each knowledge and application of guidelines was defined as scoring 70% correct answers.
The results show very low level of knowledge of guidelines among physicians with 94.6% scoring below the acceptable knowledge level. The guidelines are applied below the acceptable level with 55.6% scoring below the cut-off point. Higher level of knowledge is associated with higher position of the physician ( = 0.006), qualification held by the physician, namely, MRCGP qualification vs. MBBS ( < 0.001), and the physician's experience, namely, 10-15 years of experience vs. less than 5 years ( = 0.01). The application of guidelines is associated with position of the physician ( = 0.041). Physicians with registrar position scored higher application for guidelines than general practitioners and senior house officers.
Recognition of the low level of knowledge and application of guidelines among care providers and working toward minimizing this problem can be through education, training, and monitoring of application; this can potentially improve asthma control among patients.
尽管有有效的治疗方法和基于证据的哮喘控制指南，但未控制的哮喘水平仍然很高。护理人员对基于证据的指南的了解和遵循对于治疗至关重要。
调查沙特阿拉伯初级医疗保健机构中家庭医生对哮喘管理指南的知识掌握情况及其应用的决定因素。
这是一项横断面研究，在沙特阿拉伯利雅得的18个初级医疗保健中心进行。样本包括246名医生。向医生发放了一份自填式问卷。问卷包括人口统计学、工作特征、哮喘指南知识以及根据国际/当地指南对哮喘诊断和管理相关基本项目的哮喘指南应用问题。每个指南知识和应用的最低可接受水平定义为正确答案得分达到70%。
结果显示医生对指南的知识水平非常低，94.6%的医生得分低于可接受的知识水平。指南的应用低于可接受水平，55.6%的医生得分低于临界值。较高的知识水平与医生的较高职位相关（P = 0.006）、医生拥有的资格，即MRCGP资格与MBBS资格相比（P < 0.001）以及医生的经验，即10 - 15年经验与少于5年经验相比（P = 0.01）。指南的应用与医生的职位相关（P = 0.041）。担任注册员职位的医生在指南应用方面的得分高于全科医生和高级住院医生。
认识到护理人员对指南的知识和应用水平较低，并通过教育、培训和应用监测努力将此问题最小化，这可能会改善患者的哮喘控制情况。
