Physicians' attitudes to the pharmacological treatment of patients with stable angina pectoris

Abstract

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.

Patterns of ‘leakage’ in the utilisation of clinical guidelines: a systematic review

“…Eight surveys were distributed by mail, two by internet,8 11 and one was given to participants after a personal interview. Only two studies explicitly acknowledged using Pathman's original questionnaire 5 11. Only one survey compared physician reports with other data: namely patients' reports of their influenza vaccination within one calendar year 14…”

“…Three studies surveyed physicians <1 year after guideline publication 5 9 14. Most surveyed practice between 1–2 years after publication.…”

“…Only 12 recommendations reported data at all four steps, 12 did not report adoption, and five did not report adherence. The topic of recommendations included advice regarding: drug interventions (six topics—stable angina,5 chronic heart failure (CHF)8 and hypertension (HT),11 and prescriptions for children with asthma 611 six on anaesthetic practice guidelines in Thailand12), vaccination schedules (two studies of vaccinations given by American paediatricians and family physicians for infants,9 children3 and elderly adults14), screening tests (American gastroenterologists for surveillance at different stages of Barrett's oesophagus7; and Canadian staff physicians and residents for screening for chlamydia 13…”

Barriers to adherence to hypertension guidelines among GPs in southern Sweden: A survey

“…As no formal power calculation was performed we cannot rule out the possibility that the present study might be underpowered to address these issues. However, awareness, agreement, adoption, or adherence to hypertension guidelines in general practice or to pharmacological treatment of patients with stable angina pectoris has not been related to physicians' gender or speciality training in other studies [18,19].…”

State of the art of guidelines

“…The arguments supporting the variable views were based largely upon the results of trials that were said to have been inconclusive [33]. In another study it was found that little was known about the amount of knowledge of and attitudes towards practice guidelines on the treatment of angina [34].…”