Abstract Rationale Despite established guidelines like GINA, suboptimal asthma control remains a global issue, potentially driven by gaps in physician perception and adherence to recommendations, particularly among non-specialists who manage a large proportion of patients with SABA-based therapy. Understanding these differences is crucial to targeted educational interventions. Objectives To compare the perception and self-reported clinical practice regarding asthma diagnosis and management between specialists (strictly defined as pulmonologists, allergists, pediatric pulmonologists) and non-specialists in Brazil. Methods An online survey (PRASMA) assessing knowledge of GINA guidelines, use of spirometry, treatment strategies (ICS use, SABA overuse, AIR and MART strategies), potential differences in private and public settings, and severe asthma management (biologics) was applied to physicians across Brazil in 2025 before an asthma educational program. This abstract presents the baseline results. After 6 months the same questionnaire will be applied to assess changes as a result of the educational program and the results will be published opportunely. Descriptive statistics and Chi-squared tests were used for comparison (p 0.05 significant). Results Responses were received from 781 physicians (69 specialists, and 712 non-specialists). Specialists exhibited significantly greater in-depth knowledge of AIR (60.9%) and MART (82.6%) strategies compared to non-specialists (10.7%, and 13.2% respectively; p 0.001). Spirometry was requested for ≥51% of patients by 75.4% of specialists versus only 24.9% of non-specialists (p 0.001). In mild asthma, specialists preferred ICS+formoterol (49.3%), while non-specialists favored ICS+SABA rescue, in separated devices, (50.8%; p 0.001). For moderate asthma, ICS+formoterol (MART) was the predominant strategy among specialists (66.7%), whereas non-specialists favored ICS+LABA with SABA rescue (46.4%; p 0.001). Approximately half of respondents reported differences in their clinical practice between public and private patients (Figure 1). Conclusion These results highlight a substantial knowledge gap between specialists and non-specialists regarding evidence-based asthma management strategies, particularly AIR and MART. Specialists not only demonstrate superior familiarity but also adopt guideline-recommended approaches more consistently, such as AIR and MART strategies for both mild and moderate asthma. In contrast, non-specialists rely more on traditional regimens (ICS+SABA rescue) and rarely use spirometry, which may impact diagnostic accuracy and treatment optimization. Reported differences between public and private treatment strategies indicate systemic variability that could influence patient outcomes. These findings underscore the need for structured educational interventions and harmonization of clinical practices across care settings. Figure 1. PRASMA findings for specialists versus non-specialists regarding asthma treatment strategies (specialists, S and non-specialists, NS). This abstract is funded by: Aché Laboratórios Farmacêuticos S.A.
Rabahi et al. (Fri,) studied this question.