Attitudes of Primary Care Physicians towards the management of an Asthma Case in Tunisia

Aim:The aim of this study is to assess the attitudes of Primary Care Physicians (PCP) in Tunisia towards the management of an uncontrolled atopic young adult Asthma Case treated with inhaled Short-Acting b-agonists when needed.Method:The case was submitted online 3 months ago, and PCP were encouraged to answer by automatic scoring of the answers and feeding back of the final score.Results:After clearing the database from redundancy and incoherence, we reviewed data of 210 respondents from different regions of Tunisia who were mainly women (Sex Ratio:0.54) and aged 40 to 60 yrs-old (67%). The public-based practice was reported by 64% of respondents. Among PCP, 89% identified correctly the case as being a High Probability Asthma. Nevertheless, only 38% would initiate the treatment while 55% would choose, as an initial option, to prescribe or ask for a Pulmonary Function Testing (PFT) and 60% would indicate a chest X-Ray. Despite clearly stated as atopic, Blood cell count and IgE were indicated only by respectively 23% and 27% of respondents. Step-up strategy in this obviously uncontrolled asthma case, was, for 56% of PCP, towards prescribing an association of Inhaled Cortico-Steroids (ICS) and Long-Acting b-agonists (LABA) while 32% would manage with ICS alone. If later uncontrolled, 63% of PCP would consider the non-compliance to treatment as the main cause.Conclusion: The PCP in Tunisia showed good skills to identify a High Probability Asthma Case but most of them do not initiate treatment awaiting PFT and many would indicate a non-recommended Chest-X-Ray. The respondents do not seem to have a consensus on step-up strategy and are not enough aware of Non-compliance as the main factor of uncontrolled Asthma.Acknowledgments: The authors are grateful to Prof Habib Ghedira (Faculty of Medicine of Tunis) for advice and support. Implementation Science/Service Development Research Ideas on Respiratory Conditions and Tobacco Dependency Abstract Declaration of Interest No conflict of interest is declared by authors – Study achieved without funding References and Clinical Trial Registry Information