Survey of asthma care in Taiwan: a comparison of asthma specialists and general practitioners.

Background: Asthma is a common disease in Taiwan. The promotion of quality care for asthmatic patients should focus not only on new treatment remedies but also on patient adherence to treatment and a continuous education program integrated into treatment plans. One reason for patients' poor response to treatment is the lack of asthma knowledge on the part of physicians in terms of attitudes toward treatment.

Objective: To investigate the current status of asthma treatment among asthma specialists and general practitioners and their relative acceptance of and adherence to treatment guidelines.

Methods: One thousand questionnaires were distributed to physicians throughout Taiwan using a randomized sampling procedure. The questionnaire asked about the use of different kinds of medications, including inhaled corticosteroids, to treat asthma; adherence to asthma treatment guidelines; the use of a peak flow meter for monitoring asthma status; and self-efficacy in the treatment of asthma.

Results: A total of 526 questionnaires were returned. Of these, 90.4% of specialists and 63.2% of general practitioners would follow the guidelines for patient care (P = .002). It was significant that 79.8% of specialists but only 41.9% of general practitioners would instruct patients to use a peak flow meter to monitor symptoms (P < .001). Asthma specialists also seemed to be significantly more competent than general practitioners regarding asthma knowledge, instruction of inhalation techniques, use of peak flow meters to monitor symptoms, and making an action plan.

Conclusions: To minimize the knowledge gap between specialists and general practitioners regarding asthma treatment, recognized treatment guidelines need to be popularized or simplified. Furthermore, the continuing education of general practitioners in asthma knowledge and management skills is important.