title: Asthma in primary care: making guidelines work.
abstract: OBJECTIVE
  To determine the views of family physicians regarding selected asthma recommendations from a Canadian practice guideline and the supporting evidence, and to identify issues needing further development if family physicians are to find guideline recommendations to be truly useful clinical tools.
  
  
  METHODS
  Four urban communities in Nova Scotia, Prince Edward Island and New Brunswick.
  
  
  METHODS
  Twenty community family physicians representing different practice settings, and varying according to age and sex, were recruited to participate.
  
  
  METHODS
  Four focus groups were held, each lasting 2 h, at which recommendations from a published asthma guideline were presented for discussion on the applicability to their practices. The data were analyzed using a grounded theory method.
  
  
  RESULTS
  Physicians rely on clinical judgment in lieu of objective measures in diagnosing asthma and resist treating every exacerbation with steroids. They thought that the recommendations on smoking and patient education should have been stronger or more prominent. Patient noncompliance limits the usefulness of home peak flow measures. Topics such as allergy assessment and most pharmacological therapies triggered little discussion.
  
  
  CONCLUSIONS
  Asthma guideline developers and those interested in enhancing compliance with recommendations will need to attend to factors such as physician attitudes and beliefs on a variety of issues, including the use of objective measures and the availability of adequate resources to conduct the tests. Similarly, negative patient attitudes toward an increased use of corticosteroids suggest that a public education program would be most helpful regarding that group of recommendations.
authors.affiliation: Dalhousie University, Halifax, Canada.
authors.forename: W
authors.initials: W
authors.lastname: Putnam
authors.forename: F
authors.initials: F
authors.lastname: Burge
authors.forename: S
authors.initials: S
authors.lastname: Tatemichi
authors.forename: P
authors.initials: P
authors.lastname: Twohig
mesh_terms: D001249:Asthma / Q000517:prevention & control*; D017144:Focus Groups; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010821:Physicians, Family; D017410:Practice Guidelines as Topic