Self-reported and actual beta-blocker prescribing for heart failure patients : physician predictors

BACKGROUND: Beta-blockers reduce mortality among patients with systolic heart failure (HF), yet primary care provider prescription rates remain low.

OBJECTIVE: To examine the association between primary care physician characteristics and both self-reported and actual prescription of beta-blockers among patients with systolic HF.

DESIGN: Cross-sectional survey with supplementary retrospective chart review.

PARTICIPANTS: Primary care providers at three New York City Veterans Affairs medical centers.

MEASUREMENTS: MAIN OUTCOMES WERE: 1) self-reported prescribing of beta-blockers, and 2) actual prescribing of beta-blockers among HF patients. Physician HF practice patterns and confidence levels, as well as socio-demographic and clinical characteristics, were also assessed.

RESULTS: Sixty-nine of 101 physicians (68%) completed the survey examining self-reported prescribing of beta-blockers. Physicians who served as inpatient ward attendings self-reported significantly higher rates of beta-blocker prescribing among their HF patients when compared with physicians who did not attend (78% vs. 58%; p = 0.002), as did physicians who were very confident in managing HF patients when compared with physicians who were not (82% vs. 68%; p = 0.009). Fifty-one of these 69 surveyed physicians (74%) were successfully matched to 287 HF patients for whom beta-blocker prescribing data was available. Physicians with greater self-reported rates of prescribing beta-blockers were significantly more likely to actually prescribe beta-blockers (p = 0.02); however, no other physician characteristics were significantly associated with actual prescribing of beta-blockers among HF patients.

CONCLUSIONS: Physician teaching responsibilities and confidence levels were associated with self-reported beta-blocker prescribing among their HF patients. Educational efforts focused on improving confidence levels in HF care and increasing exposure to teaching may improve beta-blocker presciption in HF patients managed in primary care.

Medienart:	E-Artikel

Erscheinungsjahr:	2009
Erschienen:	2009

Enthalten in:	Zur Gesamtaufnahme - volume:4
Enthalten in:	PloS one - 4(2009), 12 vom: 31. Dez., Seite e8522

Sprache:	Englisch

Beteiligte Personen:	Sinha, Sanjai [VerfasserIn] Schwartz, Mark D [VerfasserIn] Qin, Angie [VerfasserIn] Ross, Joseph S [VerfasserIn]

Links:	Volltext

Themen:	Adrenergic beta-Antagonists Journal Article Research Support, U.S. Gov't, Non-P.H.S.

Anmerkungen:	Date Completed 17.03.2010 Date Revised 20.10.2021 published: Electronic Citation Status MEDLINE

doi:	10.1371/journal.pone.0008522

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	NLM194099687