Cardiovascular disease prevention counseling in residency: resident and attending physician attitudes and practices.

Abstract

PURPOSE: This study seeks to establish resident and attending physician attitudes and practice patterns with regard to cardiovascular disease (CVD) preventive counseling within a teaching hospital setting. METHODS: A 75-question survey was administered to residents and their attending physicians within a single academic medical residency program at a large, urban public hospital. RESULTS: Physician CVD risk factor counseling rates were lowest for exercise and diet (16% and 20%, respectively) and somewhat higher, although not ideal, for medication compliance and smoking (52% and 88%, respectively). Physicians did not often recommend behavior change strategies, and few physicians felt very effective in their counseling of smoking, exercise, diet, and weight reduction (25%, 24%, 27%, and 23%, respectively). Physicians acknowledged the existence of many patient, physician, and system barriers that interfered with providing more preventive counseling. There were few differences in counseling practices and attitudes between residents and attending physicians, and no significant gender differences. CONCLUSIONS: Our study found low counseling rates for CVD prevention, particularly in the areas of diet, exercise, and weight loss. Future interventions should highlight the importance of diet, exercise, and weight control in preventing CVD, and efforts should be directed toward training both resident and attending physicians, as counseling rates are low in both groups.