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Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events

BACKGROUND: Adherence to clinical practice guidelines for management of cardiovascular disease (CVD) is suboptimal. The purposes of this study were to identify practice patterns and barriers among U.S. general internists and family physicians in regard to cardiovascular risk management, and examine...

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Autores principales: Doroodchi, Hamidreza, Abdolrasulnia, Maziar, Foster, Jill A, Foster, Elyse, Turakhia, Mintu P, Skelding, Kimberly A, Sagar, Kiran, Casebeer, Linda L
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2474612/
https://www.ncbi.nlm.nih.gov/pubmed/18611255
http://dx.doi.org/10.1186/1471-2296-9-42
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author Doroodchi, Hamidreza
Abdolrasulnia, Maziar
Foster, Jill A
Foster, Elyse
Turakhia, Mintu P
Skelding, Kimberly A
Sagar, Kiran
Casebeer, Linda L
author_facet Doroodchi, Hamidreza
Abdolrasulnia, Maziar
Foster, Jill A
Foster, Elyse
Turakhia, Mintu P
Skelding, Kimberly A
Sagar, Kiran
Casebeer, Linda L
author_sort Doroodchi, Hamidreza
collection PubMed
description BACKGROUND: Adherence to clinical practice guidelines for management of cardiovascular disease (CVD) is suboptimal. The purposes of this study were to identify practice patterns and barriers among U.S. general internists and family physicians in regard to cardiovascular risk management, and examine the association between physician characteristics and cardiovascular risk management. METHODS: A case vignette survey focused on cardiovascular disease risk management was distributed to a random sample of 12,000 U.S. family physicians and general internists between November and December 2006. RESULTS: Responses from a total of 888 practicing primary care physicians who see 60 patients per week were used for analysis. In an asymptomatic patient at low risk for cardiovascular event, 28% of family physicians and 37% of general internists made guideline-based preventive choices for no antiplatelet therapy (p < .01). In a patient at high risk for cardiovascular event, 59% of family physicians and 56% of general internists identified the guideline-based goal for serum fasting LDL level (< 100 mg/dl). Guideline adherence was inversely related to years in practice and volume of patients seen. Cost of medications (87.7%), adherence to medications (74.1%), adequate time for counseling (55.7%), patient education tools (47.1%), knowledge and skills to recommend dietary changes (47.8%) and facilitate patient adherence (52.0%) were cited as significant barriers to CVD risk management. CONCLUSION: Despite the benefits demonstrated for managing cardiovascular risks, gaps remain in primary care practitioners' management of risks according to guideline recommendations. Innovative educational approaches that address barriers may facilitate the implementation of guideline-based recommendations in CVD risk management.
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spelling pubmed-24746122008-07-17 Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events Doroodchi, Hamidreza Abdolrasulnia, Maziar Foster, Jill A Foster, Elyse Turakhia, Mintu P Skelding, Kimberly A Sagar, Kiran Casebeer, Linda L BMC Fam Pract Research Article BACKGROUND: Adherence to clinical practice guidelines for management of cardiovascular disease (CVD) is suboptimal. The purposes of this study were to identify practice patterns and barriers among U.S. general internists and family physicians in regard to cardiovascular risk management, and examine the association between physician characteristics and cardiovascular risk management. METHODS: A case vignette survey focused on cardiovascular disease risk management was distributed to a random sample of 12,000 U.S. family physicians and general internists between November and December 2006. RESULTS: Responses from a total of 888 practicing primary care physicians who see 60 patients per week were used for analysis. In an asymptomatic patient at low risk for cardiovascular event, 28% of family physicians and 37% of general internists made guideline-based preventive choices for no antiplatelet therapy (p < .01). In a patient at high risk for cardiovascular event, 59% of family physicians and 56% of general internists identified the guideline-based goal for serum fasting LDL level (< 100 mg/dl). Guideline adherence was inversely related to years in practice and volume of patients seen. Cost of medications (87.7%), adherence to medications (74.1%), adequate time for counseling (55.7%), patient education tools (47.1%), knowledge and skills to recommend dietary changes (47.8%) and facilitate patient adherence (52.0%) were cited as significant barriers to CVD risk management. CONCLUSION: Despite the benefits demonstrated for managing cardiovascular risks, gaps remain in primary care practitioners' management of risks according to guideline recommendations. Innovative educational approaches that address barriers may facilitate the implementation of guideline-based recommendations in CVD risk management. BioMed Central 2008-07-08 /pmc/articles/PMC2474612/ /pubmed/18611255 http://dx.doi.org/10.1186/1471-2296-9-42 Text en Copyright © 2008 Doroodchi et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Doroodchi, Hamidreza
Abdolrasulnia, Maziar
Foster, Jill A
Foster, Elyse
Turakhia, Mintu P
Skelding, Kimberly A
Sagar, Kiran
Casebeer, Linda L
Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events
title Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events
title_full Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events
title_fullStr Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events
title_full_unstemmed Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events
title_short Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events
title_sort knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2474612/
https://www.ncbi.nlm.nih.gov/pubmed/18611255
http://dx.doi.org/10.1186/1471-2296-9-42
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