Patients with heart disease risks are more likely to be prescribed cardiovascular (CV) drugs if they see a younger doctor and recommended to change their lifestyle if they see an older doctor, according to research in the June issue of IJCP, the International Journal of Clinical Practice.
Italian researchers studied the attitudes and prescribing trends of 1,078 family doctors, cardiologists and diabetologists, together with clinical data on 9,904 of their outpatients, after inviting the doctors to take part in an educational training programme on managing CV risk.
"While physicians recognise the importance of patients' age as a major driver for CV risk, little evidence is available on the potential impact of the doctor's age on how they manage clinical risk" says cardiologist Professor Massimo Volpe from the Faculty of Medicine at Sapienza University, Rome.
"Although younger doctors prescribed more drugs, this did not result in significantly better control of their patients' major CV risk factors, suggesting that other factors have an important role to play in the clinical management of CV risk, including lifestyle changes."
The doctors, who were blind to the final purpose of the study, were selected by two-dozen regional referral centres, with 90% agreeing to take part.
All the doctors were asked to fill in questionnaires on themselves and their practice and reply anonymously on the administrative site of their regional referral centre. They were also asked to provide clinical details of the first 10 white patients over 50 they saw, for any reason, after they agreed to take part.
A fifth of the doctors (20%) were under 45 years of age, 61% were 46-55 and 19% were over 55. Female doctors accounted for 27% of the total sample and tended to be younger, ranging from 47% of those under 45 to just 8% of those over 55.
Family doctors accounted for 78% of the total sample, followed by cardiologists (13%) and diabetologists (9%). The youngest age group included the fewest GPs (53%) and most cardiologists (31%), with the highest percentage of GPs in the 46-55 age group (86%).
Just over half of the patients (54%) were male. The average age was 67 and the ages of the patients treated by the doctors in the various age groups was very similar. However, doctors over 55 tended to treat more male patients, obese patients and smokers.
Key findings of the study included:
"Our study demonstrated a significantly higher prevalence of major CV risk factors and associated clinical conditions among patients treated by younger, specialised doctors, rather than older doctors, who were more likely to be GPs" says Professor Volpe.
"Younger doctors were also more likely to prescribe medication and less likely to recommend lifestyle changes than their older colleagues. However this increased prescribing was not reflected in significantly better clinical management of CV risk factors.
"We believe these findings have important implications for the ongoing professional education of doctors treating patients with CV risk."
|Contact: Annette Whibley|