Women's Health Issues
Volume 17, Issue 2 , Pages 93-100, March 2007

Physician Knowledge Levels and Barriers to Coronary Risk Prevention in Women:

Survey Results from the Women and Heart Disease Physician Education Initiative

Presented in part at the 27th Annual Meeting of the Society of General Internal Medicine, Chicago Illinois (May 2004).

  • Janice Barnhart, MD, MS

      Affiliations

    • Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, New York
    • Corresponding Author InformationCorrespondence to: Dr. Janice Barnhart, 1300 Morris Park Avenue, Belfer Building, Room 1306A, Bronx, New York 10461; Phone: 718-430-2317; Fax: 718-430-8780.
    • ,
  • Vivian Lewis, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York
    • ,
  • Jan Laws Houghton, MD

      Affiliations

    • Department of Medicine, Albany Medical College, Albany, New York
    • ,
  • Pamela Charney, MD

      Affiliations

    • Departments of Internal Medicine, Obstetrics, Gynecology, and Women’s Health, Albert Einstein College of Medicine, Bronx, New York
    • Department of Internal Medicine, Norwalk Hospital, Norwalk, Connecticut

Received 8 December 2005; received in revised form 21 November 2006; accepted 28 November 2006.

Background

Few studies have examined whether physician knowledge, attitudes, or practice patterns might contribute to gender disparities in the primary prevention of coronary heart disease (CHD), including among physicians caring for the largest number of reproductive-age women, obstetricians and gynecologists (OB/GYNs). We sought to identify barriers affecting the provision of recommended coronary risk factor therapies in women.

Methods

We surveyed internists and OB/GYNs who attended Grand Rounds presentations developed for the New York State Women and Heart Disease Physician Education Initiative. This program was designed to improve screening and management of coronary risk factors in women. Attendees were asked to complete a 7-minute questionnaire.

Results

The mean age of the 529 respondents was 40.3 years (standard deviation = 12.3), 75.1% were internists (n = 378), and 42.7% (n = 226) were women. Physicians correctly responded to 71.5% of the 13 questions assessing knowledge of coronary risk prevention (range, 4–13). Almost one third of internists and half of the OB/GYNs did not know that tobacco use was the leading cause of myocardial infarction in young women. For patients who smoked tobacco, only two thirds of internists and 55.4% of OB/GYNs reported suggesting a quit date (p = .007). After controlling for covariates, physicians who did not perceive time as a barrier were more likely to discuss smoking cessation (odds ratio = 1.7 [1.1–2.7]).

Conclusions

Among the internists and OB/GYNs surveyed, time was perceived as a barrier to implementing risk prevention. These physicians also underestimated the impact of tobacco use as a risk factor for CHD in young women. To lessen gender disparities in CHD prevention, both specialties need time-efficient educational programs that reflect specialty differences.

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 Funded by the New York State (NYS) Department of Health, Albany, New York.

PII: S1049-3867(07)00002-3

doi:10.1016/j.whi.2006.11.003

Women's Health Issues
Volume 17, Issue 2 , Pages 93-100, March 2007

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