Physicians' attitudes to the pharmacological treatment of patients with stable angina pectoris.
BACKGROUND
Little is known about how physicians' knowledge of and attitudes to practice guidelines for stable angina may influence their implementation.


OBJECTIVE
To explore the association between physicians' demographics, their knowledge, and opinions about stable angina and their self-reported adherence to guideline recommendations.


METHODS
Questionnaire-based survey.


METHODS
We surveyed 1228 Quebec physicians using a questionnaire based on the 'awareness-to-adherence' conceptual framework to measure their adherence with recommendations for the pharmacological treatment of stable angina. Independent predictors of adherence with the targeted recommendations were determined by stepwise linear regression analysis.


RESULTS
We received 877 (71.4%) responses from the 1228 eligible physicians. More than 90% of respondents were aware of and agreed with the targeted recommendations. However, the adoption rate varied, even among physicians who generally agreed with the guidelines. Factor analysis indicated that most physicians agreed with recommendations concerning ASA. More negative attitudes were expressed toward beta-blockers and hypolipaemic drugs. Respondents trusted the recommendations of a variety of scientific and professional organizations. Awareness, agreement, and adoption were the strongest predictors of adherence for the three recommendations. Physician demographics and practice characteristics did not predict adherence.


CONCLUSIONS
Physicians were aware of and agreed with the recommendations, so additional large-scale dissemination of the guidelines would be unlikely to improve prescription patterns. However, negative attitudes about beta-blockers and hypolipaemic therapy affected adherence to recommendations for these drugs. Continuing medical education interventions involving local opinion leaders might address some of the obstacles identified.
Beaulieu
M-D
MD
Centre de recherche du CHUM, Hôpital Notre-Dame, Pavillon L.-C. Simard, 8e étage1560, rue Sherbrooke Est., Montréal (Québec), Canada H2L 4M1. maried.beaulieu@sympatico.ca
Brophy
J
J
Jacques
A
A
Blais
R
R
Battista
R N
RN
Lebeau
R
R
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy*; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011792:Quebec; D011795:Surveys and Questionnaires
D000319:Adrenergic beta-Antagonists; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors