Abstract 137: Physician Performance Gaps in Stable Ischemic Heart Disease: Assessing the Impact on Patient Care

Abstract

Study objectives: Patients with stable ischemic heart disease (SIHD) are often not managed in accordance with clinical guidelines. This study’s objective was to identify educational gaps among cardiologists, and to assess the correlation between their knowledge, skills, and attitudes with evaluating and treating patients with SIHD. Methods: A 29-question self-assessment survey was developed, including evidence-based knowledge- and case -based questions with multiple-choice and Likert scale answers, and posted online to healthcare providers for continuing medical education (CME) credit. Confidentiality of survey respondents was maintained and responses were de-identified and aggregated prior to analyses. The analysis of responses included logistic regression to determine relationships between knowledge, skills and attitudes about treatment practices in SIHD. The survey launched on April 10, 2014 and participant responses were collected through May 11, 2014. Results: In total, 134 cardiologists completed the survey. Cumulative correct scores averaged 55% among cardiologists. Only 21.6% answered 80% or more questions correctly. A significant positive relationship was found between cardiologist’s knowledge of SIHD and: –The use of exercise testing in SIHD (r = 0.202; P < 0.01) –Cardiologists’ attitudes toward the use of a patient-derived questionnaire (r = 0.280; P < 0.01)- A significant relationship was observed between educational gaps and clinical practices of cardiologists (Table). Conclusions: The significant positive relationship between cardiologists’ knowledge and their application of evidence-based practice in SIHD supports the need to develop additional education activities that align physicians’ knowledge and performance to improve patient outcomes. Future CME activities should focus on improving knowledge and attitudes of cardiologists to subsequently improve performance and patient care related to the use of validated risk-assessment tools that capture patient-reported outcomes relative to angina classification, guideline recommendations for evidence-based anti-anginal medical therapy, and treatment algorithms in patients with SIHD.