Atherosclerotic risk factor reduction in peripheral arterial diseasea: results of a national physician survey
Authors
McDermott, Mary McGraeHahn, Elizabeth A.
Greenland, Philip
Cella, David
Ockene, Judith K.
Brogan, Donna
Pearce, William H.
Hirsch, Alan T.
Hanley, Kendra
Odom, Linda
Khan, Shaheen
Criqui, Michael H.
Lipsky, Martin S.
Hudgens, Stacie
UMass Chan Affiliations
Department of Medicine, Division of Preventive and Behavioral MedicineDocument Type
Journal ArticlePublication Date
2002-12-01Keywords
AdultArteriosclerosis
Clinical Competence
Coronary Disease
Female
Health Care Surveys
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Peripheral Vascular Diseases
*Physician's Practice Patterns
Quality of Health Care
Risk Factors
Stroke
Life Sciences
Medicine and Health Sciences
Women's Studies
Metadata
Show full item recordAbstract
OBJECTIVE: Individuals with peripheral arterial disease (PAD) have a 3- to 6-fold increased risk of coronary heart disease and stroke compared to those without PAD. We documented physician-reported practice behavior, knowledge, and attitudes regarding atherosclerotic risk factor reduction in patients with PAD. DESIGN: National physician survey. PATIENTS/PARTICIPANTS: General internists (N = 406), family practitioners (N = 435), cardiologists (N = 473), and vascular surgeons (N = 264) randomly identified using the American Medical Association's physician database. MEASUREMENTS AND MAIN RESULTS: Physicians were randomized to 1 of 3 questionnaires describing a) a 55- to 65-year-old patient with PAD; b) a 55- to 65-year-old patient with coronary artery disease (CAD), or c) a 55- to 65-year-old patient without clinically evident atherosclerosis (no disease). A mailed questionnaire was used to compare physician behavior, knowledge, and attitude regarding risk factor reduction for each patient. Rates of prescribed antiplatelet therapy were significantly lower for the patient with PAD than for the patient with CAD. Average low-density lipoprotein levels at which physicians "almost always" initiated lipid-lowering drugs were 121.6 +/- 23.5 mg/dL, 136.3 +/- 28.9 mg/dL, and 149.7 +/- 24.4 mg/dL for the CAD, PAD, and no-disease patients, respectively (PCONCLUSIONS: Deficiencies in physician knowledge and attitudes contribute to lower rates of atherosclerotic risk factor reduction for patients with PAD. Reversing these deficiencies may reduce the high rates of cardiovascular morbidity and mortality associated with PAD.Source
J Gen Intern Med. 2002 Dec;17(12):895-904.