Survey Of Primary Care Physicians Research Articles

Adapting standardized patient training to improve patients’ understanding and preparedness for health care encounters

ObjectiveTo examine the impact of standardized patient (SP) training on SPs' real-life healthcare encounters and explore whether SP training elements can be adapted to increase actual patients’ understanding, communication and participation in a patient-centered care model. MethodsData were collected from surveys and focus groups with standardized patients and a survey of primary care physicians. Findings were used to create an educational video with pre- and post-viewing surveys of patients’ understanding of engagement strategies and plans to use them in future encounters. ResultsSPs reported medical visits were more productive because of their ability to understand the visit’s framework; crediting their SP training. Patients reported the video will help in planning future medical visits by providing information that increases their understanding of their role in the care process. ConclusionsSPs’ understanding of the visit and its impact on knowledge, skills and affective domains can be transferred to patients in the form of specific strategies that enhance communication and patient participation during medical visits. Practice ImplicationsA brief educational intervention for patients using SPs’ understanding of the medical visit may contribute to enhanced patient participation in future health care encounters and could increase patient engagement in patient-centered models of care.

Construct Validity Testing of the Provider Co-Management Index to Measure Shared Care in Provider Dyads.

Co-management encompasses the dyadic process between two healthcare providers. The Provider Co-Management Index (PCMI) was initially developed as a 20-item instrument across three theory-informed subscales. This study aimed to establish construct validity of the PCMI with a sample of primary care providers through exploratory and confirmatory factor analyses. We conducted a cross-sectional survey of primary care physicians, nurse practitioners, and physician assistants randomly selected from the IQVIA database across New York State. Mail surveys were used to acquire a minimum of 300 responses for split sample factor analyses. The first subsample (derivation sample) was used to explore factorial structure by conducting an exploratory factor analysis. A second (validation) sample was used to confirm the emerged factorial structure using confirmatory factor analysis. We performed iterative analysis and calculated good fit indices to determine the best-fit model. There were 333 responses included in the analysis. Cronbach's alpha was high for a three-item per dimension scale within a one-factor model. The instrument was named PCMI-9 to indicate the shorter version length. This study established the construct validity of an instrument that scales the co-management of patients by two providers. The final instrument includes nine items on a single factor using a 4-point, Likert-type scale. Additional research is needed to establish discriminant validity.

Self-reported preferences and barriers to continued professional development in primary care physicians: a cross-sectional web-based survey in Qatar

IntroductionHigh quality and effective primary healthcare is a national priority in Qatar. Continuing professional development (CPD) for physicians is a cornerstone of this objective, yet little is known about physicians’ preferences or barriers to CPD participation.MethodA needs assessment was conducted using a cross-sectional web-based survey of primary care physicians registered with the Department of Healthcare Practitioners (DHP) between March and June 2017.ResultsTwo-hundred-and-eighty-one complete surveys were submitted representing physicians in both public (N = 129) and private sectors (N = 152). Physicians completed medical degrees and postgraduate training across multiple countries, and most had been practicing in Qatar for 5 years or less. ‘Activities during working hours’, ‘cost’ and ‘work commitments’ were the most common barriers. There was little consensus regarding the optimal timing of CPD activities, although public sector physicians were more likely to indicate weekend activities as a barrier to participation (30% vs. 9%). Over 90% of participants preferred traditional lectures, workshops, case-based sessions, small group and online self-paced learning as formats for CPD delivery, however alternative modes of delivery were also deemed acceptable (> 80% agreement).ConclusionUnderstanding primary care physicians’ barriers and preferences is an essential component of a larger necessitated needs assessment of CPD in primary care practitioners in Qatar. Further research is warranted to understand the underlying beliefs driving physicians’ choices and the apparent variation between those working in the public and private sectors. CPD developers should consider approaches to mitigate perceived barriers and understand preferences to maximize the quality of participation.

The Commonwealth Fund Survey of Primary Care Physicians Reveals Challenges Experienced by Family Doctors and Emphasizes the Need for Interoperability of Health Information Technologies.

Electronic health information that is easily accessible and shareable among healthcare providers and their patients can provide substantial improvements in Canada's primary care system and population health outcomes. The Commonwealth Fund's (CMWF's) 2022 International Health Policy Survey of Primary Care Physicians (CIHI 2023) highlights the views and experiences of primary care doctors in 10 developed countries, including Canada. The survey covered various topics related to physician workload, the use of information technology and coordination of care. While the COVID-19 pandemic contributed to an increased physician workload that may have impacted the ability to efficiently coordinate care with other healthcare providers, Canadian family doctors did close the gap with other countries as 93% of family doctors are now using electronic medical records (EMRs) in their practices. The CMWF's 2022 survey revealed challenges faced by Canadian family doctors in their practices. However, international comparisons provide opportunities to learn from other countries and build on the implementation of EMRs as part of Canada's shared health priorities.

Characteristics of international primary care practices and physicians related to advance care planning: a cross-sectional survey study

BackgroundPrimary care providers (PCPs) are well-situated to delivery primary palliative care such as advance care planning (ACP). The aim of this work is to identify practice characteristics, including features found in advanced primary care models (APCMs), that predict PCP engagement of patients in ACP.MethodsWe analyzed characteristics of physician respondents and their practices associated with ACP conversations in older and sicker patients using data from 11 countries who participated in the 2015 Commonwealth Fund International Survey of Primary Care Physicians in 10 Nations. The primary outcome was how routinely these ACP conversations are reported. We used a validated measure to describe practice-level characteristics of advanced primary care models. We conducted bivariate and multivariable analyses to determine PCP and practice characteristics associated with routinely engaging patients in ACP and with documenting patient preferences in medical records.ResultsRespondents (N = 12,049) predominantly were older than 45 and did not view their jobs as high stress. PCPs reported routinely engaging patients in ACP work in practices with more APCM features. They are more likely to view their jobs as high stress, to work more hours, to practice in rural areas, and to work in smaller practices. Multivariable analyses showed that older PCP age, higher perceived stress of the job, practice location in rural areas, and increased number of APCM features were associated with more ACP conversations. Increased number of APCM features was also associated with higher odds of routinely recording patient preferences in their medical records.ConclusionsIn this international survey, physician and practice characteristics, including having features associated with APCMs, were associated with whether physicians routinely discuss ACP with patients who are older and sicker. Many features of APCMs may facilitate ACP discussions between PCPs and patients.

Do Insomnia Treatments Improve Daytime Function?

A scientific advisory panel of seven U.S. and Canadian sleep experts performed a clinical appraisal by comparing general medical opinion, assessed via a survey of practicing clinicians, regarding insomnia treatment, with the available scientific evidence. This clinical appraisal focuses on the specific statement, "Treatments for insomnia have uniformly been shown to significantly improve the associated daytime impairment seen with insomnia." The advisory panel reviewed and discussed the available body of evidence within the published medical literature to determine what discrepancies may exist between the currently published evidence base and general medical opinion. The advisory panels' evaluation of this statement was also compared with the results of a national survey of primary care physicians, psychiatrists, nurse practitioners, physician assistants, and sleep specialists in the United States. Contrary to general medical opinion, the expert advisory panel concluded that the medical literature did not support the statement. This gap highlights the need to educate the general medical community regarding insomnia treatment efficacy in pursuit of improved treatment outcomes.

Implementation strategies preferred by primary care clinicians to facilitate cancer prevention and control activities

Key clinical and community members need to be involved in the identification of feasible and impactful implementation strategies for translation of evidence-based interventions into practice. While a wide range of implementation strategies has been developed, there is little research on their applicability for cancer prevention and control (CPC) efforts in primary care. We conducted a survey of primary care physicians to identify implementation strategies they perceive as most feasible and impactful. The survey included both primary prevention behavior change counseling and cancer screening issues. Analyses contrasted ratings of feasibility and impact of nine implementation strategies, and among clinicians in different settings with a focus on comparisons between clinicians in rural vs. non-rural settings. We recruited a convenience sample of 326 respondents from a wide range of practice types from four practice-based research networks in 49 states and including 177 clinicians in rural settings. Ratings of impact were somewhat higher than those for feasibility. Few of the nine implementation strategies were high on both impact and feasibility. Only ‘adapting to my practice’ was rated higher than a 4 (“moderate”) on both impact and feasibility. There were relatively few differences between rural and non-rural clinicians or associated with other clinician or setting characteristics. There is considerable variability in perceived impact and feasibility of implementation strategies for CPC activities among family medicine clinicians. It is important to assess both feasibility and impact of implementation strategies as well as their generalizability across settings. Our results suggest that optimal strategies to implement evidence-based CPC activities will likely need to be adapted for primary care settings. Future research is needed to replicate these findings and identify practical, implementation partner informed implementation strategies.

How can social workers facilitate suicide prevention in primary care? Findings from a national survey of primary care physicians

ABSTRACT There are currently no national data regarding U.S. Primary Care Physicians’ (PCPs’) suicide screening practices. This study surveyed 302 U.S. PCPs about their current suicide screening practices to identify service gaps and intervention points for social workers. Although one-third of PCPs reported providing screening and safety planning, few were using evidence-based tools. Factors that increased the likelihood of routine screening were belief in the importance of screening (p < .01), time (p < .01), and access to co-located behavioral health (p < .01). Findings support the role of social workers in primary care and suggest areas for training and collaboration.

Abstract #1318336: Survey of Primary Care Physicians’ Screening and Treatment Practices for Prediabetes in Saudi Arabia

Prediabetes is defined as a condition in which glucose levels do not fulfill the criteria for type 2 diabetes mellitus (T2DM), indicating that the patient is at an increased risk of developing T2DM. The risk of developing T2DM can be decreased by adequately managing prediabetes. This study aimed to assess screening and therapeutic approaches to prediabetes among primary care physicians in Saudi Arabia because there are little contemporary data available on this topic.

Priorities for improvement across cancer and non-cancer related preventive services among rural and non-rural clinicians

IntroductionIt is not realistic for most clinicians to perform the multitude of recommended preventive primary care services. This is especially true in low resource and rural settings, creating challenges to delivering high-quality care. This study collected stakeholder input from clinicians on which services they most need to improve.MethodsThe authors conducted a survey of primary care physicians 9–12/2021, with an emphasis on rural practices, to assess areas in which clinicians felt the greatest needs for improvement. The survey focused on primary prevention (behavior change counseling) and cancer screening, and contrasted needs for improvement for these services vs. other types of screening, and between clinicians in rural vs. non-rural practices.ResultsThere were 326 respondents from 4 different practice-based research networks, a wide range of practice types, 49 states and included 177 clinicians in rural settings. Respondents rated the need to improve delivery of primary prevention counseling services highest, with needs for nutrition and dietary assessment and counseling rated highest followed by physical activity and with almost no differences between rural and nonrural. Needs for improvement in cancer screenings were rated higher than non-cancer screenings, except for blood pressure screening.ConclusionsBoth rural and nonrural primary care clinicians feel a need for improvement, especially with primary prevention activities. Although future research is needed to replicate these findings with different populations and other types of preventive service activities, greater priority should be given to development of practical, stakeholder informed assistance and resources for primary care to conduct primary prevention.

Physicians perceive that ostomates have decreased quality of life but not overall health: An international survey of physicians.

The aim of this work was to evaluate physicians' perceptions of ostomates' quality of life (QoL) and comfort of care among an international sample of physicians caring for ostomates. This was a cross-sectional survey study. We conducted a survey of primary care physicians (PCP), gastroenterologists (GI), and general surgeons (GS) from three continents using the SERMO online physician platform. We piloted the survey for content, clarity and domain development using a pilot sample of physicians from each speciality before use. We summarized responses to questions related to physician comfort of ostomate care with descriptive statistics. We conducted multiple logistic regression with the primary outcome of physician perception of ostomate QoL. A total of 617 physicians (PCP 264, GI 176, GS 177) completed the survey representing North America, Europe and Australia similarly. The average age was 46 years and 21% were women. Ninety per cent of physicians care for an ostomate at least once per month. Eighty eight per cent had access to enterostomal nurses. Eighty two per cent of physicians believed that ostomates have decreased QoL. Forty seven per cent believed that ostomates have decreased overall health. Almost half of respondents answered incorrectly to a 'bogus question' citing fake clinical evidence supporting a negative impact of ostomies on social relationships. Increased physician comfort in ostomy care (OR 1.30, p= 0.04) and US-based physicians (OR 1.75, p= 0.01) were associated with increased odds of answering that ostomates have no decreased QoL. Among a diverse international sample, most physicians believe that ostomates have decreased QoL but not overall health. Physician implicit bias, physician comfort and geographical variability account for these findings. Targeted efforts to increase physician comfort in ostomate care and establish universal best practices is needed.

An online survey of primary care physicians’ knowledge of common respiratory diseases in China

China has a huge population with respiratory diseases, these diseases should be managed well in primary care, however, primary care physicians’ knowledge level of these diseases were unknown. The aim of the study was to assess primary care physicians’ knowledge of asthma, CAP, COPD, and influenza in China. An e-questionnaire was distributed to attendees of respiratory diseases academic conferences in China from July, 2017 to December, 2018. 7391 questionnaires were returned and 4815 valid questionnaires were analyzed, 3802 (79.0%) from community health service centers and 1013 (21.0%) from township hospitals. The average score of the questionnaire was 83.3 (±20.397) and 72.1 (±20.898) in township and community hospitals, respectively (P < 0.05). 61.4%, 48.7%, and 42.5% of the primary care physicians were aware of clinical manifestations of COPD, asthma, and simple influenza. 85.7%, 8.1%, 16.1%, and 1.0% knew how to diagnose COPD, asthma, CAP and influenza, respectively. 94.4% of the physicians lacked the knowledge of treating COPD with bronchodilators; 53.7% knew non-pharmacological treatments for COPD. 73.6% were unable to deal with asthma attacks. 65.1% did not know what the most essential and important treatment for influenza was. 92% of physicians did not know the management for stable COPD; 3.0% knew all prevention and management measures for asthma. 37.9% knew all the preventive measures for CAP. 44.9% did not know the important role of influenza vaccine in preventing influenza and its complications. Primary care physicians in China had a poor knowledge of CAP, asthma, Influenza, COPD. There is a need for improved training of common respiratory diseases.

Physicians’ Perception About Primary Care Nurse Practitioners in Saudi Arabia

The purpose of this study was to explore physicians’ perception about the supply and demand of nurse practitioners (NPs) in primary care settings. We used a cross-sectional design and the National Survey of Primary Care Physicians and Nurse Practitioners to recruit physicians working in Saudi Arabia. Most participants agreed that the numbers of primary care physicians and NPs are less than the demand and increasing the NP supply would improve health care access and quality. Statistically significant differences were found between physicians based on demographic characteristics. Physicians support the development of the primary care NP role in Saudi Arabia to optimize health care access and quality.

General Practitioner Time Availability Per Inhabitant Per Year: A New Indicator to Measure Access to Primary Care.

The number of general practitioners (GPs) per inhabitant, used commonly as an indicator of primary care (PC) access, reports only imprecisely on the true availability of GPs. The aim of this study is to develop a new PC access indicator that better reflects the availability of GPs to take care of patients at the population level, the average GP time availability per inhabitant per year. We extracted the data from the Commonwealth Fund International Health Policy Survey of Primary Care Physicians conducted in 2015, including 11 Western countries and 12,049 randomly drawn GPs. We built the indicator by combining two questions about weekly workload in hours and percentage of time spent on face-to-face contact with patients. The indicator was then adjusted regarding the number of GPs, the weeks worked per year and the country's population size. On average, GPs worked 43 h a week. The average time spent on face-to-face contact with patients was 30.5 h/week (35 h including emails and telephone contact), ranging from 22 h in Sweden and 38 h in France. The mean time available of GPs for face-to-face contact was 69 min/inhabitant/year, ranging from 38 min in Sweden to 118 min in Australia. Including email and telephone contact, the mean contact time rose to 79 min/inhabitant/year, ranging from 48 min in Sweden to 127 min in Australia. The new indicator provides an accurate and sensitive estimate of a GP's true time availability at the population level. Results should be interpreted in the context of PC workforce organization, which may help guide GP workforce development.

Imperfect messengers? An analysis of vaccine confidence among primary care physicians

BackgroundGrowing narratives emphasize using primary care physicians as leaders in efforts to promote COVID-19 vaccination among the vaccine hesitant. Critically however, little is known about vaccine confidence among primary care physicians themselves. The objective of this study was to assess both physician confidence that in general, vaccines are safe, effective, and important, as well as physician confidence in each COVID-19 vaccine in the United States. MethodsWe rely on data from a national survey of primary care physicians conducted from May 14-May 25, 2021. We assess the influence of demographic, social, and political factors on physician beliefs that in general, vaccines are safe, effective, and important, as well as physician confidence in the safety of the Moderna, Pfizer, and Johnson & Johnson COVID-19 vaccines. Results10.1% of primary care physicians do not agree that, in general, vaccines are safe, 9.3% do not agree they are effective, and 8.3% do not agree they are important. While 68.7% of physicians were ‘very confident’ in the safety of the Moderna vaccine and 72.7% were ‘very confident’ in the safety of the Pfizer vaccine, only 32.1% of physicians were ‘very confident’ in the safety of the Johnson & Johnson COVID-19 vaccine. ConclusionA troubling proportion of primary care physicians lack high levels of vaccine confidence. These physicians may not be well positioned to actively promote COVID-19 vaccination even as political and media narratives push physicians to lead this effort. Interventions aimed at improving vaccine confidence among some physicians may be needed so that all physicians can fulfill needed roles as trusted vaccine communicators.

Survey of Primary Care Physicians' Screening and Treatment Practices for Prediabetes in Saudi Arabia.

BackgroundPrediabetes is defined as a condition in which glucose levels do not fulfill the criteria for type 2 diabetes mellitus (T2DM), indicating that the patient is at an increased risk of developing T2DM. The risk of developing T2DM can be decreased by adequately managing prediabetes. This study aimed to assess screening and therapeutic approaches to prediabetes among primary care physicians in Saudi Arabia because there is little contemporary data available on this topic.MethodologyA cross-sectional study was performed among primary care physicians in Saudi Arabia. The participants completed a validated online survey questionnaire via Google Forms. Data collected included participants’ demographic information, knowledge of T2DM risk factors, and opinions and beliefs on prediabetes management.ResultsIn total, 155 primary care physicians responded to the questionnaire; 51% were male, 18.7% worked in Riyadh City, and 81.3% specialized in family medicine. Most study respondents (71.9%) were residents, and 64.5% worked for the Ministry of Health. Overall, 93.5% of the respondents had completed part of their postgraduate training in Saudi Arabia. Moreover, 27.7% of the respondents were aware of all nine risk factors associated with T2DM. The correct fasting glucose and hemoglobin A1c ranges for the diagnosis of prediabetes were identified by 50% and 43.6% of participants, respectively. Most respondents believed lifestyle modification and metformin to be the most effective management approaches to prediabetes, whereas lack of motivation toward lifestyle changes was deemed to be a major barrier.ConclusionsWe found significant gaps in primary care physicians’ knowledge regarding prediabetes in Saudi Arabia, contributing to underscreening of the condition and undertreatment. Identifying these gaps is essential for focussing educational endeavors toward primary care physicians.

Survey of Primary Care Physicians’ Knowledge, Practices &amp; Perceptions of Prediabetes in Bahrain

Background: Prediabetes is a condition that develops before diabetes and can be treated with intensive Lifestyle Modifications (LSM). This study aimed to assess the knowledge, practices, and perceptions of Primary Care Physicians (PCPs) toward prediabetes in Bahrain. Methods: PCPs in the study were surveyed using a cross-sectional questionnaire in all 28 governmentrun Primary Healthcare Centres (PHCs) in Bahrain. We used descriptive statistics to analyse the data, which were then reported as percentages. Results: From 378 PCPs, 263 completed the questionnaire. The physician’s knowledge of prediabetes Risk Factors (RFs) and HbA1C laboratory criteria to diagnose prediabetes was inadequate. As an initial step to manage prediabetes, 12.5% of PCPs refer patients to Diabetes Prevention lifestyle change Programs (DPPs). Moreover, 15.6% recommend 7% minimum weight loss, 57.8% recommend 150 minutes per week of physical activity and 67.7% recommend prescribing metformin. Overall, our study revealed that General Practitioners (GPs) had inferior knowledge to Family Physicians (FPs). According to PCPs, diabetes prevention is hindered by both individual and system-level challenges (e.g., Inadequate motivation and resources to lose weight). Furthermore, PCPs consider that improved access to DPPs and coordinated referrals to them could delay diabetes. Conclusion: Risk stratification, appropriate diagnosis, and intervention at the prediabetes stage are of critical importance for preventing diabetes. Increasing awareness of the public regarding prediabetes complications and educating healthcare providers, especially GPs, on screening guidelines, diagnostic criteria, and evidence-based management options for prediabetes can bring us one step closer to slowing the diabetes epidemic in Bahrain. Keywords: Bahrain, Primary care physician, Knowledge, Practice, Perception, Prediabetes

A Questionnaire Survey of Primary Care Physicians on Dialects in the Hokushinetsu Region -A Quantitative and Qualitative Study of Dialects and Physicians' Perceptions-

A Questionnaire Survey of Primary Care Physicians on Dialects in the Hokushinetsu Region -A Quantitative and Qualitative Study of Dialects and Physicians' Perceptions-

[General practitioners, attitudes, procedures and challenges towards supporting family caregivers - results of a survey of primary care physicians].

ZusammenfassungHintergrund  Hausärzt*innen gelten als gut geeignet, wenn es darum geht, die Informations- und Betreuungsbedürfnisse pflegender Angehöriger zu adressieren. Ziel der vorliegenden Studie ist es, eine Bestandsaufnahme zu leisten, wie Hausärzt*innen ihre Möglichkeiten, pflegende Personen zu unterstützen, einschätzen, welche Schwerpunkte sie setzen und inwieweit sie Herausforderungen erleben. Methoden  Mittels Online-Befragung mit schriftlich-postalischem Anschreiben wurden zwischen Februar und Juni 2021 insgesamt 3556 Hausärzt*innen in Baden-Württemberg, Hessen und Rheinland-Pfalz befragt. Aufgrund des explorativen Ansatzes der Studie erfolgte ausschließlich eine deskriptive Datenanalyse. Ergebnisse  68 % der Befragten haben häufig mit pflegenden Angehören zu tun; 77 % halten die Hausarztpraxis als primäre Anlaufstelle für Pflegende und die Pflegekoordination für gut geeignet. Verbreitet kommen Betreuungssituationen zustande, indem Angehörige auf Hausärzt*innen zugehen (89 %). Häufige Inhalte betreffen eine Verschlechterung der Pflegesituation (75 %) und eine Veränderung des Pflegebedarfs (84 %); Beratungsgespräche in der Anfangsphase der Pflege sind seltener (40 %). Bei der Wahrnehmung von Bedürfnissen Pflegender und der Prioritätensetzung zeigen sich Unterschiede zwischen urbanen und ländlichen Ärzt*innen. Landärzt*innen gewichten eine proaktive und psychosoziale Betreuung stärker, wohingegen Ärzt*innen in städtischen Regionen vermehrt auf das Facharzt- und Hilfsnetzwerk setzen. Hausärzt*innen erleben diverse Herausforderungen bei der Betreuung Pflegender, darunter die zeitnahe Organisation passender Entlastungsangebote (87 %), die Vermittlung zu geeigneten Hilfsangeboten (79 %) oder die frühzeitige Identifizierung informeller Pflegepersonen (59 %). Schlussfolgerung  Die Hausarztpraxis kann eine zentrale Rolle bei der Unterstützung pflegender Angehöriger spielen. Pflegende sollten frühzeitig vom Praxisteam angesprochen und konsequent an Hilfs- und Unterstützungsangebote verwiesen werden. Zur effektiven Unterstützung einer gelingenden Pflege ist es wichtig, in der triadischen Konstellation die Bedürfnisse Pflegender und Gepflegter gleichermaßen zu berücksichtigen.

Perceptions and Barriers on the Use of Proprotein Subtilisin/Kexin Type 9 Inhibitors in Heterozygous Familial Hypercholesterolemia (From a Survey of Primary Care Physicians and Cardiologists)

Heterozygous familial hypercholesterolemia (HeFH) results in significant elevations in LDL-C and premature atherosclerotic cardiovascular disease (ASCVD). Current guidelines recommend add-on proprotein subtilisin/kexin type 9 inhibitor (PCSK9i) therapy for additional LDL-C lowering beyond statins. Data are sparse, however, regarding treatment patterns and barriers relating to PCSK9i in HeFH patients. We examined physician attitudes, use, and barriers for treatment in patients with HeFH. We surveyed 1,000 physicians (500 primary care providers [PCPs] and 500 cardiologists in the US regarding their preferred treatments, experience and barriers associated with using PCSK9is. Cardiologists compared to PCPs were more likely to rank a PCSK9i as most important for an HeFH patient needing additional LDL-C lowering (68.6% vs. 64.8%; p <0.05), as well as prescribing and having a patient on a PCSK9i. PCPs vs. cardiologists were less likely (odds ratio [OR] [95% confidence interval]=0.46 [0.34-0.63]), private vs. academic practice more likely (OR=1.53 [1.02-2.28]), and those who would prescribe a PCSK9i in an HeFH patient with (OR=3.86 [2.57-5.78]) or without (OR=1.96 [1.40-2.72]) ASCVD needing additional LDL-C reduction beyond a statin were more likely to actually prescribe a PCSK9i. Those practicing in an urban vs. rural setting were less likely (OR=0.56 [0.34-0.93]), and those indicating they would prescribe a PCKS9i in an HeFH patient with (OR=2.80 [1.74-4.49]) or without (OR=1.43 [1.02-2.02]) ASCVD needing additional LDL-C lowering beyond a statin were more likely to face difficulty prescribing a PCSK9i (all p <0.05 to p <0.01). Greater physician education and assistance among both cardiologists and PCPs are needed to address the gaps in understanding and treatment regarding PCSK9is.