Background: Pediatric asthma is a major public health concern. Although the 2021 Thai national guideline for pediatric asthma provides clear recommendations, a guideline-practice gap is suspected. This gap concerns 2 key areas: systematic asthma control assessment and age-appropriate inhaler device use. Objective: To survey the knowledge, attitudes, and practices of Thai pediatricians regarding these key guideline components. Methods: A cross-sectional study, using a validated online questionnaire, was conducted among Thai pediatricians in 2025. The questionnaire included questions on demographics, knowledge, attitudes, and practice behaviors. Data were analyzed using descriptive statistics, correlations, chi-square tests, and odds ratios (OR). Results: Ninety-nine pediatricians participated in this study. Significant gaps were observed in practice (43.4% performed systematic assessment; 40.4% routinely used the teach-back method) and knowledge (43.4% correctly identified spacer use), with 53.5% showing a permissive attitude toward accepting exceptions to spacer use. Attitude was significantly correlated with practice (r = 0.400, P < 0.001), whereas knowledge was not ( P = 0.275). Pulmonology and allergy specialists showed better attitudes (OR, 0.18; 95% confidence interval CI, 0.05–0.63 for nonadherent attitude; P = 0.008) and teach-back performance (OR, 4.60; 95% CI, 1.36–16.92; P = 0.015) than general pediatricians. Conclusion: Major gaps remain in the systematic patient assessment and reinforcement of the correct inhaler technique. Given the strong association between positive attitudes and practice, education must go beyond knowledge dissemination to foster attitudes and practical skills. This holistic approach, including interactive workshops, is recommended to improve adherence, particularly among general pediatricians.
Srichaisawat et al. (Tue,) studied this question.