Table 2.
Physician Characteristics Related to Chronic Obstructive Pulmonary Disease Management
| Parameter | Internal Medicine (n = 323) | Family and General Practice (n = 458) | P Value |
|---|---|---|---|
| Practice characteristic | |||
| Number of patients seen/day: Mean (SD) | 24.5% (12.70) | 26.0 (11.55) | .11 |
| Percent of patients with COPD | |||
| •Mean (SD) | 13.1% (10.45) | 10.6 (8.73) | < .01 |
| Spirometry in office: % (N) | |||
| •None | 36.6% (117) | 36.0% (164) | .49 |
| •Have, don't use routinely | 23.8% (76) | 20.7% (94) | |
| •Have, use routinely | 39.7% (127) | 43.3% (197) | |
| Physician perceptions | |||
|---|---|---|---|
| High confidence:* % (N) | |||
| •Detecting COPD | 35.8% (115) | 30.1% (137) | .09 |
| •Diagnosing COPD | 45.0% (144) | 33.9% (154) | < .01 |
| •Managing COPD | 34.4% (107) | 26.6% (120) | .02 |
| High optimism*: % (N) | 17.5 % (56) | 13.6% (62) | .14 |
| Inadequate exposure to COPD CME† | 54.2% (173) | 65.1 % (296) | < .01 |
| COPD guideline awareness: % (N) | |||
| •Unaware | 40.9% (131) | 48.2% (220) | .07 |
| •Aware; don't use | 33.8% (108) | 26.8% (122) | |
| •Aware; use | 25.3% (81) | 25.0% (114) | |
| Perceived barriers to COPD care | |||
|---|---|---|---|
| Most important patient-related barrier: % (N) | |||
| •Tendency of smokers to avoid medical care | 16.5% (52) | 15.6% (71) | .63 |
| •Patient nonadherence to recommended therapy | 43.3% (137) | 48.0% (218) | |
| •Presence of competing comorbid conditions | 14.2% (45) | 13.2% (60) | |
| •Low patient awareness of COPD symptoms | 26.0% (82) | 23.1% (105) | |
| Most important provider-related barrier: % (N) | |||
| •Complexity and inconvenience of spirometry testing | 19.1% (60) | 18.6% (84) | .01 |
| •Low reimbursement for COPD patient care | 21.3% (67) | 13.7% (62) | |
| •Low recognition of early COPD symptoms | 33.8% (106) | 43.4% (196) | |
| •Inadequate resources to educate and teach self-management skills | 25.8% (81) | 24.3% (110) | |
*
High confidence, high optimism = score ≥ 8 (scale: 1= not at all confident; 10 = very confident);
†
inadequate CME exposure = score ≤ 4 (scale: 1 = far too little; 5 = just right; 10 = far too much)