The aim of the study was to examine the relationship between guideline recommendations on
asthma management, and the performance of doctors in five different 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 questionnaire 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 proportion 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 treatment with
antibiotics to
steroids. They also more often associated yellow-green 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 doctors from the other three European countries.