Objectives: To describe patterns of knowledge regarding the therapeutic management of
HIV-disease and concordance with therapeutic guidelines among three groups of British
Columbian physicians and to identify possible determinants of these patterns
Methods: Anonymous questionnaires were mailed to: all registrants of a province-wide
HIV/AIDS drug treatment program (Group-G, n=659); all physicians who had a patient test
HIV positive since 1989 (Group-H, n=816); and a random sample selected from the
remaining physicians of British Columbia (Group-R, n=484). Questionnaires provided
information about: physician demographic, personal and professional characteristics; level of
current and total HIV-related experience; and knowledge of the use of therapeutic strategies
including vaccinations, clinical tests, laboratory tests and antiretroviral therapy in the context
of HIV patient care. An extended version of the survey sent to Group-G physicians requested
additional information about the management of HIV-related opportunistic infections (OIs).
Summary scores of patient care knowledge were computed by comparing physician responses
to questions pertaining to knowledge of clinical management with recommendations made in
contemporary therapeutic guidelines. Linear regression was used to identify associations
between physician characteristics and knowledge scores.
Results: Complete information was received from 38% of G-Group and 50% of Groups H
and R, with limited demographic and experiential information obtained from a further 27%,
18% and 20% of groups G, H and R respectively. Multivariate analysis revealed a significant
inverse relationship between physician knowledge and age in all groups (all p<0.02).
Increased knowledge scores were also associated with the number of active HIV positive
patients in groups G and H (all p<0.001) and lack of specialty training in groups H and R (all
p< 0.001). Regarding the additional information gathered from Group-G respondents,
physicians practising in Vancouver were more knowledgeable about 01 prophylaxis
(p=0.047) while those with medical specialty training were more knowledgeable about the
treatment of these illnesses (p=0.009).
Conclusion: The data provides evidence of substantial heterogeneity in physician's preferred
approaches to the therapeutic management of HIV disease and considerable deviation from
contemporary guidelines. The level of concordance with these guidelines is associated with
physician characteristics, most notably age, medical specially training and level of current
HIV-related experience. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate
| Identifer | oai:union.ndltd.org:UBC/oai:circle.library.ubc.ca:2429/6013 |
| Date | 11 1900 |
| Creators | Heath, Katherine Valerie |
| Source Sets | University of British Columbia |
| Language | English |
| Detected Language | English |
| Type | Text, Thesis/Dissertation |
| Format | 9517773 bytes, application/pdf |
| Rights | For non-commercial purposes only, such as research, private study and education. Additional conditions apply, see Terms of Use https://open.library.ubc.ca/terms_of_use. |
Page generated in 0.0017 seconds