Knowledge, attitude, and practice of physicians toward asthma inhaler techniques in Qassim, Saudi Arabia

Introduction: Asthma is a chronic inflammatory disease of the airways.Inflammation in airways leads to hypersensitivity and airway obstruction which is responsible for the symptoms of asthma like wheezing, dyspnea, chest tightness and cough that aggravates in the morning. The prevalence ranges from 1.1 to 9.9% in adults. Systemic therapy and inhalational therapy comprising of bronchodilators and steroids are the two major treatment options. Aims & objectives: To assess physicians knowledge, attitude & practice toward asthma inhaler devices and inhalation techniques, and classify physician's attitudes as either poor or adequate. Methodology: A cross sectional study was conducted in Qassim, Saudi Arabia among health care providers for a duration of 6 months. Practicing physicians in the three major cities in Qassim were included in the study while non-practicing physicians and those practicing in the small cities and peripheries were excluded. Data collection was done by using a predesigned self-reported online questionnaire consisting of 22 items under 3 major sections- demography, knowledge and practice of physicians. Templates were generated in MS Excel sheet and analysis of data was done using SPSS software. Chi square test was the test of significance used and p<0.05 was considered significant. Results: Metered-dose inhaler (MDI) with a spacer (56, 62.2%) was the most preferred device among dry powder inhalers (18, 20%) and nebulization solution (16,17.8%). Most of the physicians responded correctly that the first and foremost step in correct MDI inhalation was shaking the device (67, 74.4%). More than three-fifths (57, 63.3%) of physicians claimed to have taught the caregivers oneach visit to use an inhaler. The increasing age of the physician was found to be associated with a better understanding, positive attitude and good practice.A significant difference was seen based on the nationality (p 0.003) and the speciality of the physician (p 0.012) in their understanding of inhaled corticosteroids. Conclusion: Older male physicians and a family physicians rather than a general physician were found to have better knowledge and a positive attitude toward advising patients regarding inhalers.