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A survey of the knowledge of general practitioners, family physicians and pulmonologists in Nigeria regarding the diagnosis and treatment of chronic obstructive pulmonary disease.

BACKGROUND
The level of knowledge of doctors regarding chronic obstructive pulmonary disease (COPD) management impacts on their ability to appropriately diagnose and treat COPD.


OBJECTIVES
To assess the level of knowledge of Nigerian doctors regarding COPD management and explore the independent determinants of the level of knowledge.


METHODS
A questionnaire was used to assess the knowledge of general practitioners (GPs), family physicians (FPs) and pulmonologists in Nigeria regarding COPD management as recommended by the guidelines. The mean score of pulmonologists was used to set a level of standard for optimal knowledge.


RESULTS
182 doctors (56 GPs, 81 FPs and 45 pulmonologists) participated in the study. Twelve (21.4%) GPs, 46 (56.8%) FPs and 44 (97.8%) pulmonologists were familiar with the Global Initiative on Obstructive Lung Disease (GOLD) Guidelines (p<0.001). 3.6% of GPs, 11.1% of FPs and 33.3% of pulmonologists correctly selected spirometry alone for confirming a diagnosis of COPD. 12.5% of GPs, 8.6% of FPs and 40% of pulmonologists correctly identified inhaled bronchodilators and inhaled corticosteroids as the two best options for treatment of moderate to severe stable COPD (χ(2)=21, p<0.001). The overall level of knowledge was good in 64.4% of pulmonologists, 23.5% of FPs and 14.3% of GPs (χ(2)=34.2, p<0.001). The location of practice (urban versus rural), specialty of the doctors and access to spirometry were independent determinants of level of knowledge.


CONCLUSION
The level of knowledge of Nigerian doctors regarding COPD management is sub-optimal. There is a need to develop a systematic COPD education programme to improve their knowledge.