Physician Knowledge Of Guidelines Research Articles

The role of physicians' knowledge of guidelines in the usage of beta-blockers in heart failure

Background: Beta-blockers (BB) are recommended in the management of heart failure (HF), but its usage has been reported as low. The role of physicians' knowledge of guidelines in this observation has not been fully investigated. Objectives: The objective was to determine whether a gap in the physicians' knowledge of guidelines for the use of BB in HF is a reason for its low usage. Materials and Methods: Questionnaires were distributed to physicians in the Departments of Internal and Family Medicine. Multiple choice questions based on the 2016 European Society of Cardiology guidelines for the use of BB in HF were in the questionnaire. A physician was adjudged knowledgeable of the guidelines if he/she scored 50% or above. The proportion of physicians with inadequate knowledge was derived as a percentage of all respondents. Chi-square test was used to determine whether department, gender and cadre were associated with knowledge of guidelines. Results: A total of 70 physicians responded. Departments of Family and Internal Medicine, respectively. Fifty-five (78.6%) of them were not knowledgeable about the guidelines for the use of BB in HF, while only 15 (21.4%) were knowledgeable. Association between a physician's department, gender, cadre and knowledge of HF guidelines yielded P = 0.774, 0.144 and 0.227, respectively. Conclusion: There is a gap in the physicians' knowledge of the guidelines for BB use in HF. Measures to educate and regularly update physicians on HF guidelines should be institutionalised to ensure evidence-based practice, improved care and better outcomes.

Current knowledge of antibiotic prophylaxis guidelines regarding GI open-access endoscopic procedures is inadequate

The American Heart Association (AHA) guidelines from 2007 and the American Society for Gastrointestinal Endoscopy (ASGE) guidelines from 2008 recommended against antibiotic prophylaxis before GI endoscopic procedures to prevent bacterial endocarditis. To determine physician knowledge regarding these guidelines and to identify physician subgroups for which knowledge was suboptimal. A survey questionnaire was developed based on AHA and ASGE guidelines regarding antibiotics before endoscopy. Physicians were queried about 10 theoretical scenarios as to whether or not they would recommend before-procedure antibiotics. The survey was administered at 3 academic medical centers. Attending physicians and trainees in primary care and subspecialties. Survey. Percentage of the survey questions answered correctly and predictors of correct response. The survey was administered to 941 participants of whom 12 declined to participate. Eighty percent (n=740/929) of participants completed the survey. The median number of correct answers was 70% (interquartile range [IQR] 50%-90%) and was similar at each institution (P=.6). A total of 7.3% (n=54) of respondents answered all questions correctly. There was no significant difference in correct responses between attending physicians and trainees or between study centers (median 7, IQR 5-9; P=.75). Gastroenterologists were more likely to answer questions correctly than other subspecialists or primary care physicians (P<.0001). On multivariate analysis, physician knowledge correlated directly with self-reported familiarity with guidelines (0.21; 95% confidence interval [CI], 0.08-0.34; P=.002) and specialty (0.56; 95% CI, 0.30-0.82; P<.001) and inversely with year of medical school graduation (0.22; 95% CI, 0.07-0.37; P=.005). Survey study that used theoretical scenarios. Physician knowledge of guidelines regarding antibiotic use before endoscopy is suboptimal. Further interventions are needed to improve the knowledge of before-procedure guidelines.