Saudi Study Finds Low Spirometry Use Among Primary Care Doctors

A national cross-sectional study published in BMC Primary Care reveals a significant gap between the perceived importance of spirometry and its actual application among primary healthcare (PHC) physicians in Saudi Arabia. The research, led by Nowaf Y. Alobaidi and colleagues, aimed to evaluate the knowledge, attitudes, and practices (KAP) regarding spirometry use within the country’s primary care sector. Spirometry is widely recognized as the gold standard for diagnosing and monitoring chronic respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). Despite this established clinical value, the integration of the diagnostic tool into routine primary healthcare remains limited globally, prompting the researchers to investigate specific barriers and practice patterns within the Saudi context.

The study design involved a national survey distributed to PHC physicians across all regions of Saudi Arabia. The researchers utilized a modified, expert-reviewed questionnaire to assess several key domains, including physician knowledge, attitudes, practice patterns, perceived barriers, and awareness of international clinical guidelines. The data collection process was designed to capture a broad geographic distribution of participants, ensuring that the findings reflected national trends rather than isolated regional practices. Descriptive statistics were employed to summarize the overall data, while comparative analyses were conducted to examine how barriers to spirometry use differed between physicians who had access to the equipment and those who did not.

A total of 586 physicians participated in the survey, providing a substantial sample size for analyzing national-level trends. The results indicated that while the majority of participants recognized the clinical utility of spirometry, actual utilization rates were surprisingly low. More than 75% of the surveyed physicians acknowledged the importance of spirometry for diagnosing both asthma and COPD. However, this high level of awareness did not translate into frequent clinical use. Only 27.0% of the PHC physicians reported using spirometry for the diagnosis of COPD, while 25.9% reported using it for diagnosing asthma. This discrepancy highlights a disconnect between theoretical knowledge and practical implementation in primary care settings.

The study further explored the specific barriers hindering the routine use of spirometry, finding that these obstacles varied significantly depending on whether the physician had access to a device. Among physicians who did not have a spirometer available, the predominant barrier was the lack of equipment, reported by 76.3% of this group. In contrast, among physicians who did have access to a spirometer, the barriers were more operational in nature. Limited staff support was cited by 35.2% of these physicians, while restricted access to the machine itself was reported by 41.8%.

Even among the subset of physicians with access to spirometry, the frequency of use remained minimal. The study reported a median of 2 tests per week, with an interquartile range of 1 to 5 tests.

The authors conclude that despite widespread recognition of the importance of spirometry among Saudi PHC physicians, the tool remains underused in clinical practice. They emphasize that addressing these barriers is essential for strengthening respiratory care delivery and improving early diagnosis. The study suggests that a multi-faceted approach is required, including the provision of adequate equipment, workforce training, and the establishment of clear national guidelines. By identifying these specific gaps, the research provides a foundation for future educational and policy efforts aimed at enhancing the integration of spirometry into primary healthcare.

Subject of Research: Spirometry utilization and barriers among primary healthcare physicians in Saudi Arabia

Article Title: Knowledge, attitudes, and practices of primary healthcare physicians toward spirometry use in Saudi Arabia: a national cross-sectional study

Article References: Alobaidi, N. Y., Almeshari, M. A., Al Khathlan, N. A., Aldhahir, A. M., Siraj, R. A., Alqahtani, J. S., Alghamdi, S. M., Alenezi, M. A., Alruwaili, A., Faqihi, B. M., Alhomaid, T. A., Turkestani, F. A., Alhamad, B. R., Alqahtani, M. M., Alsohail, S., Alraimi, A. S., Alshammari, H. N., Alzahrani, A. A., Alanazi, M. A., … Al Ghobain, M. O. (2026). Knowledge, attitudes, and practices of primary healthcare physicians toward spirometry use in Saudi Arabia: a national cross-sectional study. BMC Primary Care. https://doi.org/10.1186/s12875-026-03569-y

Image Credits: AI Generated

DOI: 10.1186/s12875-026-03569-y

Keywords: spirometry, primary care, Saudi Arabia, COPD, asthma, diagnostic practices, healthcare barriers, cross-sectional study, Knowledge, attitudes, practices, primary