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Vol. 44. Issue 5.
Pages 245-251 (January 2008)
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Vol. 44. Issue 5.
Pages 245-251 (January 2008)
Original Articles
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Knowledge of and Attitudes and Adherence to the Spanish Guidelines for Asthma Management (GEMA) Among Spanish Health Care Professionals: The GEMA TEST Project
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Vicente Plazaa,
Corresponding author
vplaza@santpau.es

Correspondence: Dr V. Plaza Departament de Pneumologia Hospital de la Santa Creu i Sant Pau Sant Antoni M. Claret, 167 08025 Barcelona, Spain
, Ignasi Bolívarb, Jordi Ginera, María Antonia Llaugerc, Antolín López-Viñad, José Antonio Quintanoe, Joaquín Sanchisa, Montserrat Torrejóna, José Ramón Villaf
a Departamento de Pneumologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
b Servicio de Epidemiología Clínica, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
c Equip d'Atenció Primària Encants (CAP Maragall), Institut Català de la Salut (ICS), Barcelona, Spain
d Servicio de Neumología, Clínica Puerta de Hierro, Madrid, Spain
e Atención Primaria, Centro de Salud, Lucena, Córdoba, Spain
f Sección de Neumología, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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Objective

Health care professionals' adherence to asthma guidelines is believed to be low. The aim of the present study was to determine the knowledge, attitudes, and adherence of Spanish health care professionals with respect to the Spanish Guidelines for Asthma Management (GEMA).

Material and methods

A multiple choice test with 15 questions was constructed. Items assessed knowledge of and opinions and adherence to asthma guidelines in general and the GEMA in particular. Test completion was voluntary, individual, and anonymous.

Results

A total of 1066 physicians and nurses took the test. The sample consisted of 241 (22.6%) respiratory medicine specialists and 244 (22.9%) nurses from the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), 221 (20.7%) pediatric pulmonologists from the Spanish Society of Pediatric Pulmonology (SENP), 220 (20.6%) general practitioners from the Spanish Society of Family and Community Medicine (semFYC), 181 (17%) general practitioners from the Spanish Society of Rural and General Medicine (SEMERGEN), and 38 (3.6%) others. Asthma guidelines were considered useful or very useful by 805 (76%), and 771 (72%) stated they were familiar with the GEMA. However, 388 (36%) admitted that they followed guidelines seldom or never. The level of adherence to the GEMA was poor for 243 (30.3%) respondents. The multivariate analysis revealed that low adherence was associated with the following characteristics: coming from the geographic center or south of Spain; being a primary care physician, unfamiliar with guidelines, or unconvinced of their utility; and not being a user of spirometry.

Conclusions

Even though the majority of Spanish health care professionals surveyed seem to know of the GEMA, their adherence to those guidelines is very low. Educational programs that seek to improve knowledge of asthma guidelines should consider the profile of professionals with low adherence to the GEMA so as to include educational strategies that target them specifically.

Key words:
Asthma
Asthma therapy
Spanish guidelines for the management of asthma (GEMA)
Objetivo

Se sospecha que el seguimiento de las recomendaciones terapéuticas del asma entre los profesionales sanitarios es bajo. El presente estudio se ha realizado con el objeto de determinar la opinión, el conocimiento y cumplimiento de las recomendaciones de la Guía Española para el Manejo del Asma (GEMA) entre los profesionales sanitarios españoles.

Material y métodos

Se elaboró un cuestionario de 15 preguntas de respuesta múltiple que recogían la opinión y conocimiento general sobre las guías de asma, el grado de seguimiento de éstas y, específicamente, de las recomendaciones diagnósticas y terapéuticas de la GEMA. El cuestionario se cumplimentó de forma voluntaria, individual y anó-nima.

Resultados

Rellenaron el cuestionario 1.066 profesionales: 241 (22,6%) neumólogos y 244 (22,9%) profesionales de enfermería de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR); 221 (20,7%) pediatrasneumólogos de la Sociedad Española de Neumología Pediátrica (SENP); 220 (20,6%) médicos de atención primaria de la Sociedad Española de Medicina de Familia y Comunitaria (semFYC); 181 (17%) médicos de atención primaria de la Sociedad Española de Medicina Rural y Generalista (SEMERGEN), y 38 (3,6%) de otras sociedades. De ellos, 805 (76%) opinaron que las guías para el manejo del asma eran útiles o muy útiles y 771 (72%) conocían la GEMA, pero 388 (36%) reconocían que seguían poco o nunca sus recomendaciones. Entre los médicos participantes, 243 (30,3%) fueron clasificados como malos cumplidores de la GEMA. El análisis multivariante reveló que los profesionales provenientes de las áreas centro y sur españolas, los de atención primaria, los poco convencidos de la utilidad de las guías o los que no las conocen, y los que no empleaban la espirometría se asociaron con un menor cumplimiento de la guía.

Conclusiones

Si bien la mayoría de los profesionales sanitarios españoles encuestados conoce y estima positiva la GEMA, el grado de cumplimiento de ésta es bajo. Los futuros programas docentes encaminados a difundir las guías de asma deberían considerar el perfil del médico no cumplidor de la GEMA e incorporar estrategias educativas dirigidas específicamente a dichos profesionales.

Palabras clave:
Asma
Guías de tratamiento del asma
Guía Española para el Manejo del Asma (GEMA)
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Copyright © 2008. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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