Practising physician's knowledge and patterns of practice regarding the asplenic state: the need for improved education and a practical checklist.
OBJECTIVE
To examine physicians' knowledge and actions regarding the asplenic state and to develop a practical checklist to aid in the systematic education and management of asplenic patients.


METHODS
A prospective cohort survey utilizing an experienced nurse practitioner and a survey questionnaire with on-site interviews.


METHODS
The Okanagan Valley, British Columbia.


METHODS
A cohort of 122 physicians serving a population base of 350,000.


METHODS
Beliefs and practices relating to vaccination and precautions necessary for adult and pediatric splenectomized patients.


RESULTS
The majority of physicians appeared to be knowledgeable about potential conditions affecting splenic function, except in the case of severe liver disease with portal hypertension and collagen vascular disease. There appeared to be good understanding on the part of most physicians of the risks associated with various infectious diseases and the asplenic state, except in the case of Capnocytophaga canimorsus infection linked to dog bites and the increased susceptibility of asplenic patients to intraerythrocytic parasites. Although a majority of physicians were cognizant of the need for pneumococcal vaccination and other immunizations in adults, there was marked uncertainty in relation to the need and the appropriate time interval for revaccination. In the case of children there appeared to be uncertainty regarding the role of antibiotic prophylaxis. There were discrepancies between physicians' expressed attitudes and the actions actually taken for asplenic patients in individual practices.


CONCLUSIONS
Further education is required concerning the management of asplenic patients. The systematic use of a practical checklist may facilitate this process.
Brigden
M L
ML
Penticton Hospital Cancer Clinic, BC.
Pattullo
A
A
Brown
G
G
D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002983:Clinical Competence; D004522:Educational Status; D006801:Humans; D007239:Infections / Q000209:etiology; D010818:Practice Patterns, Physicians'; D011314:Preventive Health Services; D011446:Prospective Studies; D012307:Risk Factors; D013156:Splenectomy / Q000009:adverse effects*; D011795:Surveys and Questionnaires