Survey of recognition and utilization of guidelines for the diagnosis and management of bronchial asthma in Japan


Dr S. Makino, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu, Shimotsuga-gun, Tochigi 321-0204, Japan


Background: In Japan in 1993, the Japanese Society of Allergology (JSA) developed guidelines for diagnosis and management of asthma (JGL), which were based on the concept that asthma is a chronic inflammatory disorder of the airway.

Methods: This survey study was intended to investigate the recognition and utilization of JGL among physicians who had treated asthma. The survey comprised two methods: a quantitative mail survey and a qualitative door-to-door survey conducted by trained interviewers.

Results: In the mail survey, a total of 1028 physicians responded; 552 members of the JSA and 476 nonmembers. Ninety-four percent of JSA members were aware of adult asthma management guidelines, while 53 nonmembers were aware of them. Although approximately half of the physicians, both member and nonmember, found differences between the asthma management policies in JGL and their previous policies, most of them utilized JGL, once they read it. In the qualitative door-to-door survey, 80–90% of physicians evaluated JGL as good after they read it.

Conclusions: JGL was recognized and utilized by most JSA members, but only half of nonmember physicians were aware of JGL, although they utilized JGL after they read it. Further action to implement JGL among nonspecialist physicians is needed to improve management of asthma.