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J Family Med Prim Care. 2018 Sep-Oct;7(5):927-936. doi: 10.4103/jfmpc.jfmpc_189_18.

Determinants of family medicine physicians' knowledge and application of asthma management guidelines at primary healthcare centers in Riyadh, Saudi Arabia.

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Department of Family Medicine, Prince Sultan Military Medical City, Riyadh, KSA.



The level of uncontrolled asthma is still high despite the availability of effective treatments and evidence-based guidelines for controlling asthma. Knowledge and adherence to evidence-based guidelines among care providers are crucial to the treatment.


To investigate the determinants of family physicians' knowledge and application of asthma management guidelines at primary healthcare setting in Saudi Arabia.


This is a cross-sectional study, conducted at 18 primary healthcare centers in Riyadh, Saudi Arabia. The sample consisted of 246 physicians. A self-administrated questionnaire was distributed among the physicians. The questionnaire included demographic, job characteristics, knowledge of asthma guidelines, and application of asthma guidelines' questions about the essential items related to diagnosis and management of asthma according to the international/local guidelines. The minimum acceptable level for each knowledge and application of guidelines was defined as scoring 70% correct answers.


The results show very low level of knowledge of guidelines among physicians with 94.6% scoring below the acceptable knowledge level. The guidelines are applied below the acceptable level with 55.6% scoring below the cut-off point. Higher level of knowledge is associated with higher position of the physician (P = 0.006), qualification held by the physician, namely, MRCGP qualification vs. MBBS (P < 0.001), and the physician's experience, namely, 10-15 years of experience vs. less than 5 years (P = 0.01). The application of guidelines is associated with position of the physician (P = 0.041). Physicians with registrar position scored higher application for guidelines than general practitioners and senior house officers.


Recognition of the low level of knowledge and application of guidelines among care providers and working toward minimizing this problem can be through education, training, and monitoring of application; this can potentially improve asthma control among patients.


Bronchial asthma; Global Initiative for Asthma; Saudi Initiative for Asthma; guidelines; primary care

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