Abstract
Objective
The Healthy Heart Kit (HHK) is a risk management and patient education kit for the prevention of cardiovascular disease (CVD) and the promotion of CV health. There are currently no published data examining predictors of HHK use by physicians. The main objective of this study was to examine the association between physicians’ characteristics (socio-demographic, cognitive, and behavioural) and the use of the HHK.
Methods
All registered family physicians in Alberta (n=3068) were invited to participate in the “Healthy Heart Kit” Study. Consenting physicians (n=153) received the Kit and were requested to use it for two months. At the end of this period, a questionnaire collected data on the frequency of Kit use by physicians, as well as socio-demographic, cognitive, and behavioural variables pertaining to the physicians.
Results
The questionnaire was returned by 115 physicians (follow-up rate = 75%). On a scale ranging from 0 to 100, the mean score of Kit use was 61 [SD=26]. A multiple linear regression showed that “agreement with the Kit” and the degree of “confidence in using the Kit” was strongly associated with Kit use, explaining 46% of the variability for Kit use. Time since graduation was inversely associated with Kit use, and a trend was observed for smaller practices to be associated with lower use.
Conclusion
Given these findings, future research and practice should explore innovative strategies to gain initial agreement among physicians to employ such clinical tools. Participation of older physicians and solo-practitioners in this process should be emphasized.
Key words: Cardiovascular medicine, clinical practice guidelines, evidence based medicine, family medicine, primary care
Résumé
Objectif
La trousse Coeur en santé est une trousse de gestion des risques et d’éducation des patients pour la prévention des maladies cardiovasculaires et la promotion de la santé cardiovasculaire. Actuellement, il n’existe aucune donnée publiée examinant les indicateurs prévisionnels pour l’utilisation de la trousse Coeur en santé par les médecins. Le principal objectif de cette étude est d’examiner l’association entre les caractéristiques des médecins (sociodémographiques, cognitives et comportementales) et l’utilisation de la trousse.
Méthode
Tous les médecins de famille de l’Alberta (n=3068) ont été invités à participer à l’étude sur la «trousse Coeur en santé». Les médecins consentants (n=153) ont reçu la trousse et on leur a demandé de l’utiliser pendant deux mois. À la fin de cette période, un questionnaire a permis de recueillir les données sur la fréquence de l’utilisation de la trousse par les médecins, ainsi que les variables sociodémographiques, cognitives et comportementales relatives aux médecins.
Résultats
Le questionnaire a été retourné par 115 médecins (taux de suivi = 75 %). Sur une échelle allant de 0 à 100, la note moyenne pour l’utilisation de la trousse était de 61 [écart type=26]. Une régression linéaire multiple a démontré que «le consentement à utiliser la trousse» et le degré de «confiance dans l’utilisation de la trousse» étaient fortement associés à l’utilisation de la trousse, ce qui explique 46 % de la variabilité de l’utilisation de la trousse. Le temps écoulé depuis l’obtention du diplôme était inversement associé à l’utilisation de la trousse, et on a observé une tendance pour les plus petits cabinets associés à une utilisation moins fréquente.
Conclusion
Étant donné ces résultats, les prochaines recherches et les prochains exercices devraient examiner des stratégies innovatrices pour obtenir l’accord initial parmi les médecins d’employer de tels outils cliniques. La participation des médecins plus âgés et des médecins exerçant seuls à ce processus devrait être mise en évidence.
Mots clés: médecine cardiovasculaire, lignes directrices sur les pratiques cliniques, médecine fondée sur des preuves, médecine de famille, soins primaires
Footnotes
Acknowledgements: Dr. Bize holds salary support from The Swiss National Science Foundation. Dr. Plotnikoff is supported from Salary Awards from the Canadian Institutes of Health Research (Applied Public Health Chair) and the Alberta Heritage Foundation for Medical Research (Health Scholar). Dr. Scott received funding from the Canadian Institutes of Health Research, Alberta Heritage Foundation for Medical Research and the Canadian Child Health Clinician Scientist program to support this work. We would like to acknowledge the Alberta College of Family Physicians for their assistance and provision of the family physicians contact information, and the University of Alberta for funding this project.
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