Self-Reported and Actual Beta-Blocker Prescribing for Heart Failure Patients Physician Predictors 英文参考文献.docVIP

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Self-Reported and Actual Beta-Blocker Prescribing for Heart Failure Patients Physician Predictors 英文参考文献.doc

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Self-Reported and Actual Beta-Blocker Prescribing for Heart Failure Patients Physician Predictors 英文参考文献

Self-ReportedandActualBeta-BlockerPrescribingfor HeartFailurePatients:PhysicianPredictors SanjaiSinha1,2*,MarkD.Schwartz3,4,AngieQin3,4,JosephS.Ross1,5 1DepartmentofMedicine,JamesJ.PetersVAMedicalCenter,Bronx,NewYork,UnitedStatesofAmerica,2DepartmentofMedicine,MountSinaiSchoolofMedicine, New York, New York, United States of America, 3Department of Medicine, VA New York Harbor Healthcare System, New York, New York, United States of America, 4DepartmentofMedicine,NewYorkUniversitySchoolofMedicine,NewYork,NewYork,UnitedStatesofAmerica,5DepartmentofGeriatricsandAdultDevelopment, MountSinaiSchoolofMedicine,NewYork,NewYork,UnitedStatesofAmerica Abstract Background: Beta-blockers reduce mortality among patients with systolic heart failure (HF), yet primary care provider prescriptionratesremainlow. Objective: To examine the association between primary care physician characteristics and both self-reported and actual prescriptionofbeta-blockersamongpatientswithsystolicHF. Design:Cross-sectionalsurveywithsupplementaryretrospectivechartreview. Participants:PrimarycareprovidersatthreeNewYorkCityVeteransAffairsmedicalcenters. Measurements: Main outcomes were: 1) self-reported prescribing of beta-blockers, and 2) actual prescribing of beta- blockersamongHFpatients.PhysicianHFpracticepatternsandconfidencelevels,aswellassocio-demographicandclinical characteristics,werealsoassessed. Results: Sixty-nine of 101 physicians (68%) completed the survey examining self-reported prescribing of beta-blockers. Physicians who served as inpatient ward attendings self-reported significantly higher rates of beta-blocker prescribing amongtheirHFpatientswhencomparedwithphysicianswhodidnotattend(78%vs.58%;p=0.002),asdidphysicians whowereveryconfidentinmanagingHFpatientswhencomparedwithphysicianswhowerenot(82%vs.68%;p=0.009). Fifty-one of these 69 surveyed physicians (74%) were successfully matched to 287 HF patients for whom beta-blocker prescribing data was available. Physicians with greater self-r