Asthma management in five European countries: doctors' knowledge, attitudes and prescribing behaviour

The aim of the study was to examine the relationship between guideline reco mmendations on asthma management, and the performance of doctors in five di fferent European health care contexts, Knowledge, attitudes and prescribing behaviour of doctors recruited to an educational project was investigated. A total of 698 general practitioners from Germany, the Netherlands, Norway and Sweden, and 94 specialists from the Slovak Republic participated. A que stionnaire was used to assess their knowledge and attitudes, Antiasthmatic drugs dispensed to their patients reflected their prescribing behaviour. In response to questions on how to treat chronic asthma, most doctors were in agreement with guideline recommendations. In practice, however, the prop ortion of asthma patients receiving inhaled steroids varied almost twofold, ranging 31% in Germany to 58% in the Netherlands. On questions related to exacerbation of asthma, German and Slovakian doctors often preferred treatm ent with antibiotics to steroids. They also more often associated yellow-gr een sputum with bacterial infection. In conclusion, although many doctors in different health care contexts have accepted the recommendations given in guidelines, the proportion of their patients treated accordingly differed. German and Slovakian doctors seem to attach less importance to the inflammatory features of asthma than the doc tors from the other three European countries.