A gap analysis of delivery of asthma care in Sri Lanka: Emphasizing the role of general practitioners and challenges

Background: Asthma is a significant and growing public health burden in Sri Lanka, with an estimated prevalence of 9–12% among the general population and even higher rates reported in children and urban communities. Poorly controlled asthma leads to frequent exacerbations, hospital admissions, and impaired quality of life, placing pressure on the health system. In Sri Lanka, general practitioners (GPs) are often the first point of contact in the healthcare system and play a pivotal role in delivering ongoing asthma care within primary care settings. Despite their central role, asthma control remains suboptimal, and few studies have examined how GPs perceive and approach their responsibilities in asthma management. This study explored GPs’ insights into asthma care in Sri Lanka. Methods: A qualitative study was conducted with 17 general practitioners (GPs) from all provinces of Sri Lanka who were recruited through purposive and snowball sampling to ensure diverse regional representations. The key informant interviews, which were conducted via a structured interview guide, were audio-recorded, transcribed verbatim, and analysed via reflexive thematic analysis to identify patterns and key issues in asthma care delivery. Results: The analysis led to the construction of two major themes. The first was insufficient emphasis on asthma as a long-term disease , which included subthemes such as prioritization of acute care over long-term prevention, deficient patient education on preventive strategies, fragmented service delivery due to a lack of integrated records, and inadequate follow-up compounded by time constraints. The second theme focused on patient misconceptions about asthma and its treatment , including fears about the dependence and side effects of inhalers, stigma associated with the asthma diagnosis, and misunderstandings about triggers and chronicity. These factors significantly impact patient adherence and hinder the adoption of guideline-based asthma management. Conclusions: This study highlights key barriers to effective asthma management in Sri Lankan general practice, including an acute care focus, limited patient education, and widespread misconceptions about asthma and inhaler use. Addressing these challenges requires enhanced GP training, improved follow-up systems, and culturally sensitive patient education strategies to support long-term asthma control.