General Practitioners’ and Trainees’ Knowledge of the Asthma Guidelines in Germany: a cross-sectional Survey

Background: Asthma treatment in Germany does not always comply with German treatment guidelines (AG) even though great importance is attached to medical guidelines worldwide. Suboptimal asthma management can lead to poor health outcomes. Barriers to guideline implementation and adherence must therefore be identified and analyzed. As 90% of asthma patients initially contact the German health system via a general practitioner (GP), GPs are pivotal to asthma care. Objectives: As a determinant of compliance with AG, we investigated GPs’ and GP trainees’ knowledge of AG recommendations. Methods: As part of a larger study, a cross-sectional survey on guideline knowledge was conducted in Lower Saxony and Bavaria, Germany. All GP trainees and a sample of GPs from both regions were invited to complete a questionnaire concerning asthma definition, clinical findings, diagnostic tests, differential diagnostics, treatment and prevention. Responses were analysed using descriptive and comparative statistics. Results: Fifty percent of 585 GPs and GP trainees participated. Trainees attained a mean score of 57%. (Bavarian trainees scored 58% and Lower Saxon trainees 55%). GPs obtained 58%, without significant regional differences. Significant differences between GPs’ and trainees’ scores were observed in the areas of asthma definition, clinical findings and diagnostic tests. Both trainees and GPs performed best in differential diagnostics but least well in the fields of prevention and clinical findings. Conclusion: Our results suggest suboptimal knowledge of all areas of the AG. More efforts should be made to implement the guidelines and improve the knowledge of GPs and GP trainees.