title: Management preferences of pediatricians in moderate and severe acute asthma.
abstract: OBJECTIVE
  To assess and compare management preferences of physicians for moderate and severe acute asthma based on case scenarios and to determine the factors influencing their decisions.
  
  
  METHODS
  A questionnaire based on the Global Initiative on Asthma (GINA) guideline and comprising eight questions on management of acute asthma was delivered to participants of two national pediatric congresses. Management of moderate and severe acute asthma cases was evaluated by two clinical case scenarios for estimation of acute attack severity, initial treatment, treatment after 1h, and discharge recommendations. A uniform answer box comprising the possible choices was provided just below the questions, and respondents were requested to tick the answers they thought was appropriate.
  
  
  RESULTS
  Four-hundred and eighteen questionnaires were analyzed. All questions regarding moderate and severe acute asthma case scenarios were answered accurately by 15.8% and 17.0% of physicians, respectively. The initial treatment of moderate and severe cases was known by 100.0% and 78.2% of physicians, respectively. Knowledge of the appropriate plan for treatment after 1h was low both for moderate (45.0%) and severe attacks (35.4%). Discharge recommendations were adequate in 32.5% and 70.8% of physicians for moderate and severe attacks, respectively. Multiple logistic regression analysis revealed that working at a hospital with a continuing medical education program was the only significant predictor of a correct response to all questions regarding severe attacks (p = .04; 95%CI, 1.02-3.21). No predictors were found for information on moderate attacks.
  
  
  CONCLUSIONS
  Pediatricians have difficulty in planning treatment after 1 hour both for moderate and severe asthma attacks. Postgraduate education programs that target physicians in hospitals without continuing medical education facilities may improve guideline adherence.
authors: Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey. mustafarga@gmail.com
authors: Mustafa
authors: M
authors: Arga
authors: Arzu
authors: A
authors: Bakirtas
authors: Ferhat
authors: F
authors: Catal
authors: Oksan
authors: O
authors: Derinoz
authors: Erdem
authors: E
authors: Topal
authors: M Sadik
authors: MS
authors: Demirsoy
authors: Ipek
authors: I
authors: Turktas
mesh_terms: D000328:Adult; D019468:Disease Management; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D016015:Logistic Models; D008297:Male; D010820:Physicians; D010818:Practice Patterns, Physicians'; D013224:Status Asthmaticus / Q000628:therapy*; D011795:Surveys and Questionnaires