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Physician attitude, awareness, and knowledge regarding guidelines for transcranial Doppler screening in sickle cell

Sarah L Reeves1, Heather J Fullerton2, Kevin J Dombkowski3

  • 1University of Michigan, Ann Arbor, MI, USA sleasure@umich.edu.

Clinical Pediatrics
|October 17, 2014
PubMed

Insights

Physician knowledge gaps and perceived barriers hinder adherence to transcranial Doppler (TCD) screening for children with sickle cell disease. Improving physician education and addressing external factors are crucial for guideline implementation.

Area of Science:

  • Pediatric Neurology
  • Hematology
  • Medical Education

Background:

  • Sickle cell disease (SCD) increases stroke risk in children.
  • Transcranial Doppler (TCD) ultrasonography is recommended for stroke risk screening in SCD.
  • Physician adherence to TCD screening guidelines is essential for early detection and prevention.

Purpose of the Study:

  • To investigate factors influencing physician adherence to TCD screening guidelines in pediatric SCD.
  • To identify internal (physician-related) and external (system-related) barriers to TCD screening.
  • To compare adherence and perceived barriers across different physician specialties.

Main Methods:

  • A mailed survey was distributed to 706 pediatric hematologists, neurologists, and primary care physicians in May 2012.
  • The survey assessed physician knowledge, self-efficacy, and perceived internal and external barriers to TCD screening.
  • Responses were analyzed using chi-square tests to compare data across specialties.

Main Results:

  • Of 276 surveyed physicians, 141 treated children with SCD, and 72% recommended TCD screening.
  • A significant majority of primary care physicians (66%) felt uninformed about TCD guidelines, unlike neurologists (25%) and hematologists (6%).
  • Knowledge assessment scores were low (13%-35%), and external barriers included distance to vascular labs and low patient adherence.

Conclusions:

  • Physician knowledge deficits and low self-efficacy regarding TCD screening recommendations require further investigation.
  • Addressing physician-perceived barriers and enhancing educational outreach are vital for improving TCD screening adherence.
  • Optimizing TCD screening protocols can enhance stroke prevention strategies in pediatric SCD patients.
Abstract

Keywords:
childrenguidelinessickle cell diseasesurveytranscranial Doppler ultrasonography

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