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Physician specialty is associated with differences in warfarin use for atrial fibrillation
1Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Alberta. kellenj@acs.ucalgary.ca
Objective:
To determine whether physician specialty is associated with prescription of warfarin to elderly persons with atrial fibrillation.
Design:
Cross-sectional survey.
Setting:
One hundred and thirty-eight randomly selected general practitioners--all 58 internists and all 27 cardiologists in southern Alberta were surveyed by mail.
Intervention:
Physicians identified their preferred drug for stroke prevention generally and in response to two hypothetical cases.
Main Results:
Response rates were 66% (general practitioners), 76% (internists) and 89% (cardiologists). Specialists (92%) were more likely than general practitioners (76%) to choose warfarin (P = 0.007). Findings were similar for questions related to case scenarios; however, the magnitude of differences between specialists and general practitioners was less pronounced. Specialists were more likely (77%) to prescribe warfarin for elderly females than were general practitioners (62%, P = 0.08). Similar proportions of specialists (77%) and general practitioners (67%) would prescribe warfarin to elderly males.
Conclusion:
Physician specialty is associated with warfarin prescription for elderly persons with atrial fibrillation.