The attitude, knowledge and behavior of family physicians about childhood asthma in Sakarya province

OBJECTIVE AND BACKGROUND: Asthma is the most common chronic disease of childhood. In this study, it was aimed to determine the knowledge, attitude and the behavior of family physicians working in family health centers (FHCs) in Sakarya province about childhood asthma disease. MATERIALS AND METHODS: A total of 172 physicians were included in the study, who accepted the study. In the first part of the 4-part questionnaire consisting of 46 questions, the attitudes and behaviors of the family physicians about childhood asthma disease, in the second part; the age, gender, year of graduation, title of the family physicians, the district where they work, the presence of mobile service duty, the number of registered asthmatic patients, frequency of asthma drugs prescribing, frequency of asthmatic patient examination, presence of asthmatic patients in their relatives, presence of brochures or leaflets on asthma in FHCs, presence of asthmatic patients in family, participation in training on asthma, status of being visited by drug representative concerning the asthma medication were questioned. The number of correct answers given to 11 theoretical knowledge questions and 16 clinical case questions about 2 cases in part 3 and 4 were determined. Knowledge questions and their answers were prepared on the basis of the Global Strategy for Asthma Management and Prevention-Revised 2017, a globally recognized report on the study of Global Initiative for Asthma (GINA). RESULTS: A total of 172 physicians participated in the study, including 144 certificated general practitioners, 7 family medicine specialists, 21 contracted family medicine residents. The majority of the family physicians who participated in our study were between 41-50 years old (39.5%) male (62.2%). The other most frequent characteristics are as follows: years of graduation from medical school was 10 to 20 years (36.7%), working in central district (62.2%), have no mobile health service duty (61%), have between 1-10 registered asthmatic patients (38.4%), frequency of seeing asthma patient under 18 years of age is at least once per week (41.3%), the frequency prescription for the asthma patients under 18 years of age is at least once per week (43.6%), don't have asthma patients among relatives (59.3%), have banners or brochures about asthma in FHC (58.1%), neither read a scientific article nor attended a meeting on asthma within the previous year (58.1%), had a visit by a drug representative concerning asthma within the previous year (51.7%), not attended any training on asthma organized by the Ministry of Health (60.5%). In the first part family physicians' attitudes and behavior about the patients under 18 years of age in the FHC conditions are questioned. 44.2% of participants agreed that family physicians can diagnose asthma, 61.6% accepted follow-up and maintenance treatment of asthma can be done and 86% approved mild asthma attack treatment can be given. In questions where behavior is questioned as for the asthma patients under 18 years of age who apply to FHCs, 44.6% of the participants stated they would always-often refer the patients to a higher-level health care facilities. 92% of them always-often question whether patients' disease is under control or not and 79.7% always-often remind patients the techniques of using inhaler drugs and preventive measures against triggers. It was observed that age, gender, the title, the district worked, the time since graduation, the visit of the drug representative and the frequency of prescribing the asthma medications were the characteristics of the family physicians that make a significant change in their attitude and behavior. The factors affecting the success in the knowledge questions of the questionnaire were to be family medicine specialist or resident, to work in the central district, not to have banners or brochures on asthma in FHC. Although family medicine specialists, residents and physicians working in the central district gave more correct answers to clinical case questions, they did not participate in the opinion of managing asthma attack; they were less likely to question whether patients' disease is under control or not and to remind patients the techniques of using inhaler drugs and preventive measures against triggers. It was observed that the general practitioners questioned the patients' control status more frequently and reminded the asthmatic patients more about the triggers and the use of the inhaler drugs than the family medicine specialists and residents; and they had the opinion that asthma attack treatment could be given. However, when their correct answers to the question of control parameters were compared, it was seen that the family medicine specialists and residents gave significantly more accurate answers to the questions than the general practitioners. CONCLUSION: Based on the sociodemographic characteristics of the family physicians, with the updated information and theoretical and practical training to be given, more asthma patients can be taken under control and as a result, the morbidity, mortality and social costs associated with asthma may be reduced.