Poison prevention counseling - A comparison between family practitioners and pediatricians

Objectives: To compare the current opinions and practices of family practit ioners with those of pediatricians regarding poison prevention anticipatory guidance (PPAG) and to further assess which factors, if any, are associate d with providing counseling on this topic. Design: Cross-sectional mail survey. Participants: Family practitioners and pediatricians throughout the United States and Puerto Rico, randomly selected from the membership list of the A merican Medical Association. Main Outcome Measure: Reported frequency of providing parents with PPAG. Results: Of the 1000 physicians surveyed, 975 were eligible and 500 returne d surveys that could be analyzed (227 family practitioners and 273 pediatri cians), for a response rate of 51.3%. The majority of physicians in each fi eld (family practice, 81.9%; pediatrics, 87.2%) reported that they believe it is their responsibility to provide PPAG to parents (P = .08). Family pra ctitioners, however, were less likely than pediatricians to provide parents with PPAG (66.5% vs 91.9%; P<.001). When adjusted for other variables, suc h as age and sex, family practitioners were 5.4 times less likely than pedi atricians to provide parents with PPAG (odds ratio, 0.19; 95% confidence in terval, 0.09-0.37). Family practitioners, more often than pediatricians, ci ted lack of training on poisoning prevention as a reason for not providing parents with PPAG (46.1% vs 18.2%; P = .02). Among all physicians, those wh o received postresidency training on PPAG were more likely to provide PPAG than those who had not received postresidency training on this topic (odds ratio, 3.21; 95% confidence interval, 1.44-7.18). Having received residency training on poisoning prevention, however, did not increase the likelihood of providing PPAG (odds ratio, 1.69; 95% confidence interval, 0.86-3.30). Conclusions: Although it is currently recommended to include PPAG as part o f the routine preventive pediatric care, this study shows that one third of family practitioners do not provide parents with PPAG. Family practitioner s should increase their efforts aimed at poisoning prevention. Those involv ed with training residents in family practice and pediatrics should place g reater emphasis on this topic to increase the impact of this training on ac tual PPAG practices.