Knowledge of asthma management by general practitioners in Karachi, Pakistan: Comparison with international guidelines

Background: Suboptimal management of asthma by general practitioners (GPs) can lead to poor health outcomes Aims: To assess the management of common asthma presentations by GPs using the Global Initiative for Asthma (GINA) guidelines as a comparative tool. Methods: A cross-sectional survey was conducted in Karachi, Pakistan. Of 250 GPs approached, 192 completed a self-administered questionnaire regarding pathology, key history points, risk factors, diagnosis, and management of asthma. Results: Overall, 28.6% of GPs had adequate knowledge of the core concepts of asthma, while only 10.4% had adequate practice in asthma management. About 78% of GPs had inadequate knowledge of pathology, about 90% had inadequate knowledge of medications to be used, and 63% had inadequate knowledge regarding diet restrictions. Knowledge regarding symptoms not usually associated with asthma was adequate, as was knowledge regarding non-pharmacological management (79% each). Practices regarding asthma diagnosis were good (99.0%). However, practices regarding acute exacerbations and patients who wish to exercise were inadequate in 85.9% and 82.8% of GPs, respectively. Conclusions: The majority of GPs had poor knowledge and practice of asthma. We recommend initiation of programmes to improve their knowledge and practices.