Lyme Disease Knowledge, Attitudes, and Practices Among Surveyed Clinicians in Western North Carolina, 2022-2023

Lyme disease has expanded into western North Carolina. We sought to document knowledge, attitudes, and practices among clinicians in this region.

A survey was administered to clinicians in western North Carolina. Frequencies summarized Lyme-related care. Fisher's exact test compared low-knowledge items (<75% correct) by provider type, clinical experience, and regional tenure. Likert-type items measured attitudes; open-ended responses identified education barriers.

Among 28 participants, 59% (16/27) saw a suspected Lyme case in the past year. The median knowledge score was 59% (interquartile range: 47-73%), with low confidence interpreting test results (median Likert score = 2, interquartile range: 1-3). Correct identification of erythema migrans timing differed by regional tenure (≤5 years: 16/18 [89%]; >5 years: 3/8 [38%]; p = 0.014). Recognition of when testing is not recommended differed by provider type (physician: 11/20 [55%], nurse practitioner: 0/6 [0%]; p = 0.024). Perceived education barriers included cost, time, and small patient population.

Overall, knowledge was limited, particularly for diagnostic testing. Clinicians in emerging communities should be prioritized for educational interventions.