Perceptions and practices of primary care physicians in rural India for diagnosis and management of asthma and COPD: a questionnaire survey

Abstract

<b>Background:</b> In India, chronic respiratory diseases, especially asthma and COPD, are common public health problems. For individuals, chronic respiratory symptoms are disabling, and affect the quality of life. We aimed to understand the perceptions and practices of primary care physicians (“GPs”) who provide the majority of healthcare in rural India. <b>Methodology:</b> We administered a short questionnaire to all public and private GPs in the Junnar block, Pune district (n»432). The survey asked about qualifications and working arrangements, and about if/how they managed patients with asthma and COPD. The analysis was descriptive. <b>Results:</b> We approached 340 (78.7%) of the 432 GPs and collected data from 255 (75.0%). Non-responders were too busy treating and managing COVID-19 patients so could not spare time. The GPs had between 1 and 50-years’ experience in clinical practice (mean 48.3, SD 9.3). 38.4% had an MBBS qualification and practiced modern medicine (Allopathy). 53.7% only had qualifications in alternative systems of medicine (Ayurveda and Homeopathy) however, 59.5% of these also provide modern medical services. 25.3% provided both alternative and modern medical services. Of the 255 responders, 181 (71.3%) treat/manage asthma, 131 (51.0%) treat/manage COPD and 97 (38.0%) treat/manage both asthma and COPD. Overall, 63% had access to in-patient facilities. <b>Conclusion:</b> Many GPs practicing modern medicine only had qualifications in Ayurveda and Homeopathy.&nbsp;Fewer GPs are involved in the management of COPD as compared to asthma. We will use these data to purposively sample for qualitative interviews about the management of asthma and COPD