Compliance of primary care doctors with asthma guidelines and related education programs: the employment factor.

BACKGROUND Primary care physicians' adherence to accepted asthma guidelines is necessary for the proper care of asthma patients. OBJECTIVES To investigate the compliance of primary care physicians with clinical guidelines for asthma treatment and their participation in related educational programs, and to evaluate the influence of their employment status. METHODS A questionnaire was administered to a random sample of 1,000 primary care practitioners (pediatricians and family physicians) in Israel. RESULTS The response rate was 64%. Of the physicians who participated, 473 (75%) had read and consulted the guidelines but only 192 (29%) had participated in an educational program on asthma management in the last 12 months. The younger the responding physician (fewer years in practice), the more likely his/her attendance in such a program (p < 0.0001). After consulting the guidelines 189 physicians (40%) had modified their treatment strategies. Significantly more self-employed than salaried physicians had read the guidelines and participated in educational programs; physicians who were both self-employed and salaried fell somewhere between these groups. This trend was not influenced by the number of years in practice. CONCLUSIONS All primary care physicians should update their knowledge more often. The publication of guidelines on asthma must be followed by their proper dissemination and utilization. Our study suggests that major efforts should be directed at the population of employed physicians.