Prevalence and barriers of providing written asthma action plan by primary care physicians in Saudi Arabia (2019); a multivariate regression analysis

Abstract

Background: Personalized written asthma action plans (WAAP) can assist self-management of asthma and improve management outcomes. In Saudi Arabia, data assessing the adherence with providing WAAP are decidedly lacking. Objective: To determine the prevalence of providing WAAP and its perceived barriers by family physicians. Methods: A cross-sectional study was conducted among family physicians working in family medicine clinics of Prince Sultan Military Medical City (Riyadh, Saudi Arabia) during November 2019. Physicians were asked to fill in a researcher-made study questionnaire that included potential WAAP barriers. IBM© SPSS© Statistics version 21 was used for statistical analyses. Results: Out of 202 physicians included in the current study, only 34 (16.8%) were providing WAAP for their patients with asthma. Only 6.8% of the patients seen by the study physicians were receiving WAAP. In multivariate logistic regression analysis, larger number of patients encountered per month and non-adherence of patients to management plans were significantly associated with providing WAAP. Odds ratios (OR) were "OR: 1.02, 95% CI: 1.01-1.04, p=0.009" and "OR: 3.33, 95% CI: 1.40-7.87, p=0.006. On the other hand, lack of awareness with WAAP recommendations was significantly associated with not providing WAAP (OR: 0.19, 95% CI: 0.04-0.89, p=0.035). Conclusions: The finding confirms the low utilization of WAAP at primary care setting in Saudi Arabia, which is probably reflecting a limited education and training rather than a negative attitude towards WAAP. The findings underscore the need to raise the awareness of family physicians with WAAP recommendations and the need to fix some workflow issues.