Hyperbaric oxygen therapy and diabetic foot ulcers: knowledge and attitudes of Canadian primary care physicians

To explore physicians' knowledge of and attitudes toward hyperbaric oxygen therapy (HBOT) in order to better understand current diabetic foot ulcer management practices and to determine potential barriers to HBOT use.

A 24-item questionnaire.

Primary Care Today conference in Toronto, Ont, in May of 2006.

Physician attendees, 313 of whom completed the survey.

Self-reported knowledge of and attitudes toward HBOT.

Less than 10% of respondents had a good knowledge of HBOT, but 57% had a good attitude toward HBOT. Knowledge of and attitude toward HBOT were positively correlated (P < .0001). Good knowledge of HBOT was associated with sex (P = .0334), age younger than 40 years (P = .0803), years in medical practice (P = .0646), patient requests for HBOT referrals (P = .0127), and having previously referred patients for HBOT (P < .001). Twenty years or more in medical practice (P = .0593) and receiving patient requests for HBOT (P = .0394) were multivariate predictors of having good knowledge of HBOT. Good attitude toward HBOT was associated with age younger than 40 years (P = .0613) and having previously referred patients for HBOT (P = .0013). Multivariate analysis showed that male physicians (P = .0026) received more patient requests for HBOT (P < .0001), had good knowledge (P = .0129) and a good attitude (P = .0488), and were more likely to refer patients for HBOT.

Primary care physicians have underdeveloped knowledge of HBOT, but their generally positive attitudes toward its use suggest that they might be receptive to educational interventions. Educating both physicians and patients about HBOT, specifically its cost-effectiveness, might encourage future use.