
Guideline based knowledge and practice of physicians in the management of COPD in a low‐ to middle‐income country
Author(s) -
Ghimire Suraj,
Lamichhane Anish,
Basnet Anita,
Pandey Samiksha,
Poudel Nahakul,
Shrestha Bhushan,
Pathak Santosh,
Mahato Gaurav,
Shrestha Ram Kumar
Publication year - 2022
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.13468
Subject(s) - medicine , copd , guideline , spirometry , family medicine , referral , cross sectional study , asthma , pathology
Background Chronic obstructive pulmonary disease (COPD) is the third leading cause of death, with 80% of the total death occurring in low‐ to middle‐income countries (LMICs). Nepal is one of the LMIC; COPD is a highly prevalent and significant public health issue often underdiagnosed. Medical physicians' good knowledge and practice to diagnose and treat COPD can help reduce the disease burden. Objectives To determine the level of knowledge, practice and factors influencing the practice of physicians regarding COPD management based on GOLD guidelines. Design A cross‐sectional descriptive study using a structured questionnaire was conducted among medical physicians working in Bagmati and Gandaki province of Nepal. Out of total scores, physicians knowledge and practice were graded according to Bloom's original cut‐off point for good (≥80%), satisfactory (60%–78%) and poor (<60%). Result A total of 152 medical physicians participated in this study. Out of the possible total score 20, the mean score on knowledge was 17.8 ± 2.4, and out of possible total score eight, the mean score on practice was 5.3 ± 1.3. The correlation test between total knowledge and practice scores showed r = 0.18 and p value <0.02. The most selected factors hindering the appropriate management of COPD was lack of patient follow up and lack of professional training in COPD. Other factors included patient unwillingness to discuss smoking quit plan, lack of screening tool, unavailability of spirometry and physician unawareness of available medicine to treat COPD. Conclusion Despite physicians having good knowledge in COPD, the practice in COPD management is below guideline‐recommended. There is a significant, very low positive correlation between total knowledge score and practice score. Proper COPD training to physicians, disease awareness among patients, easy availability of diagnostic equipment and medication can help improve physicians' practice and appropriately manage COPD patients.