The purpose of this study was to measure and evaluate GPs' practices, perceptions, and beliefs with regard to chronic childhood asthma management and to identify GPs' attitudes towards practice guidelines in particular the SACAWG (South African Childhood Asthma Work Group) guideline (Motala et al., 2000). In 2001 a single period cross-sectional survey was conducted among 300 GPs in the Nelson Mandela Metropole (NMM) which comprised the Port Elizabeth, Uitenhage, and Despatch regions. GPs in clinical practice in the NMM were identified from the register of the Health Professions Council (HPC) CD-ROM (2000). The register contains names and professional information on all physicians in South Africa who have completed or in the process of completing requirements to practice medicine. GPs meeting the following criteria were identified: (1) primary self-designated practice specialty of general practice; (2) practice location in Port Elizabeth, Uitenhage, and Despatch areas; and (3) engaged in direct patient care. The HPC register contained listings for 300 GPs that matched the study criteria. Data were collected by means of a structured self-administered questionnaire. Questionnaires with a return envelope were mailed to the GPs' practices. Questionnaires were returned by 89 of the 300 eligible NMM GPs, reflecting a 29,7 % response rate. A 43-item Chronic Childhood Asthma Management questionnaire was developed and validated to assess the delivery of asthma care by GPs in the NMM. Forty-four per cent of the respondents reported performing spirometry on patients with newly diagnosed asthma as part of their initial evaluation. For patients with moderate persistent asthma prescribing of inhaled corticosteroids (ICSs) varied by patient age, with 57,4% of physicians routinely prescribing them for patients < 5 years, compared with 76,5% of physicians prescribing them for patients 5 years. Awareness of the SACAWG guidelines among these GPs was high, with 76,8% reporting that they have heard of the guidelines, and 59,4% reporting having read them. 14,5 per cent of the GPs reported developing written treatment plans for patients with moderate or severe asthma. To achieve the best results with their asthma patients, 68,1% of the physicians reported that patient compliance was imperative, 49,3% reported education as the most important, pharmacotherapy / good products was reported as most important by 29,0% of the group, environmental control was cited by 18,8% of the GPs. Several aspects of the SACAWG guidelines appear to have been incorporated into clinical practice by GPs in the NMM, whereas other recommendations do not appear to have been readily adopted. This information suggests areas for intervention to improve primary care for asthma in the NMM.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:nmmu/vital:10825 |
| Date | January 2003 |
| Creators | Wickens, Nicolas John |
| Publisher | Port Elizabeth Technikon, Faculty of Health Sciences |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis, Masters, MTech (Biomedical Technology) |
| Format | ix, 142 leaves, pdf |
| Rights | Nelson Mandela Metropolitan University |
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