title: Physicians' attitudes toward guidelines for the treatment of hospitalized nursing home-acquired pneumonia.
abstract: OBJECTIVE
  To assess physician awareness, attitudes, and barriers toward the 2005 American Thoracic Society (ATS)/Infectious Diseases Society of America (IDSA) guidelines for the treatment of hospitalized nursing home-acquired pneumonia (NHAP).
  
  
  METHODS
  We conducted a cross-sectional survey of 522 health care providers. The survey assessed the practice setting characteristics, physicians' attitudes, and reported awareness of the 2005 ATS/IDSA guidelines. Factor analysis was conducted to identify scales of variables, and a reliability analysis was performed to verify the reliability of the identified scales.
  
  
  RESULTS
  Three hundred and ten completed the survey. Most responders (88%) reported familiarity with the practice guidelines in their field, but less than half were familiar with the ATS/IDSA NHAP guidelines. Although attitude scores regarding clinical practice guidelines did not differ significantly among various disciplines (P = .63), there were 2 characteristics that correlated with positive attitudes toward the 2005 ATS/IDSA guidelines in a multivariate analysis: being a pulmonary specialist (P ≤ .001) and time spent on CME activity per month (P = .03). The main barriers to the 2005 ATS/IDSA guidelines implementation were lack of awareness, concerns about practicality of using the recommended regimens, increased cost, lack of documented improved outcomes, and potential conflict with other guidelines.
  
  
  CONCLUSIONS
  The study indicates low levels of awareness with the 2005 ATS/IDSA guidelines for treatment of hospitalized NHAP. Targeted intervention efforts including outcome assessment and cost-effective analysis may be necessary to improve adherence with the proposed guidelines.
authors.affiliation: The Veterans Affairs Western New York Healthcare System, Buffalo, NY 14215-1199, USA. solh@buffalo.edu
authors.forename: Ali A
authors.initials: AA
authors.lastname: El-Solh
authors.forename: Ahmad
authors.initials: A
authors.lastname: Alhajhusain
authors.forename: Ranime G
authors.initials: RG
authors.lastname: Saliba
authors.forename: Paul
authors.initials: P
authors.lastname: Drinka
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D017714:Community-Acquired Infections / Q000188:drug therapy*; D003428:Cross Infection / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D010820:Physicians / Q000523:psychology*