Knowledge of the Global Initiative for Asthma (GINA) guidelines among Doctors in Tertiary Hospitals in South-South Nigeria.

Background: The GINA guidelines have become the "gold standard" in the management of asthma. A good understanding by physicians of these guidelines is an essential step in applying the GINA guidelines to patient care. This study aimed to assess physician's knowledge of the GINA guidelines among Physicians in South-South Nigeria. Study Design: 31 multiple choice questions based on recommendations of GINA guidelines were distributed to physicians of all cadre who manage adult asthma patients in three tertiary hospitals in South-South Nigeria. Result: 87 physicians completed the test including physicians in respiratory unit (4), physicians in Family Medicine (20) and physicians in Internal Medicine (63). The mean total score for all physicians who took the test was 39.7 ± 14.5 % (mean ± SD). Pulmonologists recorded the highest total score (68.5 ± 5.5%) followed by Internists (38.8 ± 13.5%) then by Family Physicians (37.1 ± 13.2%). The Consultants had the highest average total score (49.0 ± 11.7%) followed by Senior Residents (40.8 ± 17.4%), Junior Residents (40.7 ± 13.5%), Medical Officers (35.5 ±0.0%) finally the House Officers (31.5 ± 13.6%). Physicians performed best in questions concerning disease diagnosis but the poorest scores were obtained in questions concerning asthma education. Less than a third had attended any CME after graduation. Conclusion: The physicians' understanding of the GINA guidelines is generally poor. Specialist training in respiratory diseases did improve scores. The findings of this survey may provide some explanation to poor level of asthma control.