Barriers and facilitators to the prescription of automated external defibrillators for home use in patients with heart disease: A survey of cardiologists

OBJECTIVE: Because the majority of cardiac arrests occur at home, the use o f automated external defibrillators (AEDs) in the home could potentially im prove survival of out-of-hospital cardiac arrest, Currently physicians must prescribe AEDs for home use hy patients. The purpose of this study was to investigate the harriers and facilitators to prescription of home use of AE Ds. DESIGN: Telephone interviews were conducted with 85 cardiologists and paper and pencil surveys (via fax) with 59 additional cardiologists in Washingto n State. OUTCOME MEASURES: Cardiologists were asked about their current practices an d their perceived barriers and facilitators to prescription of AEDs for hom e use. RESULTS: Eighty-five percent of the sample believed that AEDs could be effe ctive in preventing death, although only 7% of the cardiologists had ever p rescribed an AED. Reasons for nonprescription included the use of implantab le cardioverter defibrillators, perceived lack of a clear patient niche, aa d lack of knowledge about the device. The majority of respondents reported that they would be more likely to prescribe AEDs if they were the standard of care (71%), were covered by insurance (67%), and came with comprehensive training (58%). CONCLUSION: The results showed that cardiologists believe that home use of AEDs call be effective but what many issues regarding the prescription of A EDs remain.