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Cardiovascular disease. Physician attitudes toward prevention and treatment
A M Grant1, T Niyonsenga, I Dion
1Clinical Research Centre, Centre universitaire de santé de l'Estrie, Québec. a.grant@courrier.usherb.ca
Objective:
Survey of physician attitudes toward practising cardiovascular disease prevention.
Design:
Questionnaire administered via telecommunication from 1992 through 1994.
Setting:
The FAMUS (Family Medicine, University of Sherbrooke) project, between 1992 and 1996, used weekly telecommunication to collect data from 200 general practitioners throughout the province of Quebec on cardiovascular disease risk factors and their treatment.
Participants:
Of 200 physicians contributing to the FAMUS project, 156 completed questionnaires (response rate 78%).
Main Outcome Measures:
Variations in attitudes to prevention policy and risk factor interventions.
Results:
Survey results revealed physicians knew important risk factors for cardiovascular disease but differed in attitudes toward efficacy of treatment. Intervention to control cholesterol was thought to be very effective by 21.2% (95% confidence interval [CI] 21.2 +/- 6.4) and without effect by 10.3% (95% CI 10.3 +/- 4.8). Intervention to improve dietary habits was considered ineffective by 48.1% (95% CI 48.1 +/- 7.8). Confidence in managing risk factors varied; most respondents described themselves as only moderately skilled. A few practitioners (30.1%; 95% CI 30.1 +/- 7.2) acknowledged practice guidelines as an important source of information on which to base preventive interventions. Only 14.7% (95% CI 14.7 +/- 5.6) of those surveyed included remuneration as contributing to their implementation of prevention activities in practice.
Conclusions:
Variations in physician attitudes could influence risk factor intervention. Interventions to change lifestyle are associated with uncertainty about patient compliance, efficacy of treatment, and ability to effect lifestyle changes.