CARDIOVASCULAR-DISEASE - PHYSICIAN ATTITUDES TOWARD PREVENTION AND TREATMENT

OBJECTIVE Survey of physician attitudes toward practising cardiovascul ar disease prevention. DESIGN Questionnaire administered via telecommu nication from 1992 through 1994. SETTING The FAMUS (Family Medicine, U niversity of Sherbrooke) project, between 1992 and 1996, used weekly t elecommunication to collect data from 200 general practitioners throug hout the province of Quebec on cardiovascular disease risk factors and their treatment. PARTICIPANTS Of 200 physicians contributing to the F AMUS project, 156 completed questionnaires (response rate 78%). MAIN O UTCOME 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 atti tudes toward efficacy of treatment. Intervention to control cholestero l 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). Inter vention 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 pra ctitioners (30.1%; 95% CI 30.1+/-7.2) acknowledged practice guidelines as an important source of information on which to base preventive int erventions. Only 14.7% (95% CI 14.7+/-.5.6) of those surveyed included remuneration as contributing to their implementation of prevention ac tivities in practice. CONCLUSIONS Variations in physician attitudes co uld influence risk factor intervention. Interventions to change lifest yle are associated with uncertainty about patient compliance, efficacy of treatment, and ability to effect lifestyle changes.