PURPOSE: Purpose: Although the management of patients with asthma in Nigeria is largely performed by general practitioners (GPs), no previous study in the country has evaluated asthma management among them. We designed this study to assess the knowledge of drug treatment of asthma among GPs in North Central Nigeria.
METHODS: Methods: This was a cross sectional survey among 149 GPs in the capital cities of 3 states in North Central Nigeria. The participants completed a self-administered questionnaire that elicited information about their knowledge of drug treatment of asthma and attendance at update on asthma management.
RESULTS: Results: Combination of bronchodilators, in form of intravenous Aminophylline (91.3%) and salbutamol (79.2%), was usually prescribed for acute severe asthma. The residents training in general medical practice were more likely to prescribe inhaled salbutamol (mainly as Metered dose inhalers) than other categories of GPs (Odd ratio=6.1, CI=1.7-26.7). Nebulization was rarely prescribed. Systemic steroid (mainly intravenous) was prescribed for acute severe attacks by 80.5% GPs. Aberrant prescription for acute attack such as inhaled salmeterol/fluticasone, antibiotics, antitussives, antimalaria and analgesics were prescribed by 35 (23.5%) GPs. For mild uncontrolled asthma during follow up visits, oral steroid (59.7%) and oral salbutamol (49.7%) were commonly prescribed. Inhaled salmeterol/fluticasone (as dry powder inhaler) was prescribed by 32 (21.5%) GPs. The fellows in general medical practice prescribed more inhaled salmeterol/fluticasone than other categories of GPs (OR=7.7, CI=1.8-39.0). The prescribing pattern of GPs in private and public settings was similar. Attendance at update on asthma management was generally poor among all categories of GPs. Seventy one (47.7%) of them had never attended any update on asthma management whereas only 24 (16.1%) attended any form of update within the last year prior to this survey.
CONCLUSION: Conclusion: There is gross lack of knowledge of asthma treatment among GPs in North Central Nigeria. Poor attendance at update on asthma management contributes significantly to this problem.
CLINICAL IMPLICATIONS: Clinical Implications: Regular CMEs will have a great impact on asthma management in Nigeria.
DISCLOSURE: Ademola Fawibe, No Financial Disclosure Information; No Product/Research Disclosure Information