A study on physicians’ knowledge and practices of asthma management in Angola

Abstract

Background: Asthma is the most common chronic non-communicable disease in children and one of the most common in adults, and the majority of asthma-related deaths are attributed to middle- and low-income countries. Physicians’ knowledge and practice have been recognized as fundamental elements in the approach to the asthmatic patient with an impact on the treatment and control of the disease. This study aimed to assess the knowledge and practice of Angolan physicians in the management of asthma, as well as to identify the main gaps. Methods: It was a cross-sectional study carried out in Angola. The data were collected through an online questionnaire to assess the knowledge about asthma among the physicians and the Physicians Practice Assessment Questionnaire. Categorical variables were described with frequencies and percentages. All associations between good practice and possible predictors were established with logistic regression analysis. P<0.05 was considered statistically significant. Results: A total of 204 physicians throughout Angola participated; the majority of whom were female, aged ­between 31 and 40, and from the Luanda province. The average percentage of correct answers for all domains was 65.8% (±SD11.1%). The lowest percentages were in the answers about the diagnosis, drugs, and the signs of an asthma attack. Out of the 204 participants, 81.9% of physicians confirmed seeing patients with asthma. The average percentage of them who reported practicing asthma management based on recommended guidelines was 59.8% (±SD27.8%). More than half of the physicians did not achieve that percentage. The lowest percentages of correct answers concerned assessment of the inhaler technique, provision of a written referral for asthma education, and use of the GINA guidelines to assess the patient’s asthma control. Concerning the predictors of best practices, our results showed that being a physician of older age and with more work experience, as well as having the category of specialist were significant predictors of adherence to recommended practices for asthma management. Conclusions: The physicians’ level of knowledge about asthma was moderate, but there are important practical gaps in asthma management regarding standard guidelines.