Adherence to the latest GINA guidelines among family physicians and internists in Jordan: A cross-sectional study

Asthma is a common chronic lung disease that causes significant morbidity and potential mortality all around the world. Since family medicine and internal medicine physicians, most frequently encounter asthmatic patients, updating their knowledge about the latest. Global Initiative for Asthma (GINA ) guidelines is important for proper asthma management. This study aims to assess the level of knowledge of family medicine and internal medicine physicians in Jordan about the latest GINA guidelines, and possibly to lay out future research and practice recommendations that need to be done for better management outcomes of this condition. A cross-sectional study using an online survey was conducted to investigate the degree to which the current clinical practice for asthma management in Jordan is based on the latest GINA guidelines. A total of 177 responses to the online questionnaire were included in our study, and the Maintenance and Reliever Therapy (MART) dosing approach was examined. Although awareness of the MART strategy was high (72.9%, 129/177), its implementation as first-line therapy for mild asthma (the cornerstone of the GINA 2023 guidelines) was low. Only 20.9% (37/177) of all physicians prescribe MART for mild asthma, which was the adherence group. While 39.0% (69/177) still prescribe short-acting beta agonists (SABA)-only for mild or moderate asthma. Furthermore, a significant proportion (58.2%, 103/177) of physicians who used MART often or always co-prescribed a SABA as a reliever, contrary to guidelines. There was no statistically significant difference between family medicine and internal medicine in terms of the adherence (P-value = .167). The adherence to guidelines group was significantly associated with more follow-up with patients' adherence to their maintenance treatments compared with the nonadherence group (P-value < .001). The primary source of knowledge on MART was the GINA guidelines themselves (71.3%, 92/129). Despite good awareness of GINA guidelines among Jordanian physicians, a significant gap exists between knowledge and implementation, particularly concerning the persistent use of SABA in mild asthma. This practice misalignment shows that guidelines dissemination alone is insufficient. Bridging this gap needs multiple strategies that address systemic barriers, practical education, and changes in policy. These steps will help turn guidelines into real practice and improve patient outcomes.