Diagnosis and management of childhood asthma: How far we have reached? A survey of pediatrician′s knowledge, attitude, and practices from Rajasthan

Abstract

Background: Despite the development and propagation of guidelines for the diagnosis and management of asthma, a gap remains between current recommendations and actual practice. Objectives: To assess the paediatrician`s attitude towards asthma guidelines and their adherence to its recommendations. Materials and Methods: 131 pediatricians engaged in direct childhood asthma care in state of Rajasthan were subjected to a self-administered questionnaire with 50 questions of which most were multiple choices, aiming at assessment of three important aspects about the involved pediatricians; paediatrician`s knowledge, practice and attitude. Results: Agreement with asthma guidelines was present with 87% of the studied pediatricians, however those who are not in agreement with the guidelines claimed that this was mainly due to patient factors and low socioeconomic status. Poor knowledge was found in 37%, poor practice in 49% and poor attitude in 19% of the studied physicians. Our study revealed that proper prescription of corticosteroids was carried out by only 56% of pediatricians. Significant number of doctors prescribed antihistamines, antibiotics and dietary restrictions on all asthmatic children and nebulisers/inhalers remained under-used. Pediatricians relied commonly on journals, company brochures, and conferences to keep themselves updated. Conclusion: The attitude of the majority of the studied pediatricians revealed agreement with the guidelines, while the disagreement was mainly explained by the poor socioeconomic standard of the patients. The degree of poor practice is more marked than that of poor knowledge or poor attitude reflecting resources limitations and application obstacles in the pediatricians's practice.