Pressure ulcers in adults: Family physicians' knowledge, attitudes, practice preferences, and awareness of AHCPR guidelines

BACKGROUND. Little is known about physicians' knowledge, attitudes, and practice preferences with regard to pressure ulcers. Clinical practice guidelines on pressure ulcers from the Agency for Health Care Policy and Research (AHCPR) have been publicized, but their impact on family physicians has not been assessed. METHODS. A questionnaire was sent to a random sample of active members of the Minnesota Academy of Family Physicians. Information was collected on respondent demographics, practice characteristics, training, and awareness of AHCPR guidelines. Knowledge about pressure ulcers was assessed with a 43-item test. Attitudes about pressure ulcer treatment were measured on a Likert-type scale. Four case scenarios were used to explore preferences. RESULTS. Of 292 potential respondents after exclusion, 155 (53.1%) returned questionnaires. Regression analysis revealed that taking care of more elderly patients, completing a residency, being board- certified, and being aware of the AHCPR guidelines were independently associated with higher knowledge scores. Virtually all (99%) the respondents felt that it was the family physician's role to provide pressure ulcer care, whereas 70% felt that they had not been adequately trained to do so. There was a wide variety of practice preferences. Approximately 70% of physicians were not aware of the AHCPR guidelines. CONCLUSIONS. Most family physicians feel ill-prepared to manage pressure ulcers, suggesting a need to increase educational efforts for this important problem. Knowledge about pressure ulcers could possibly be enhanced by more clinical exposure to older patients, rigorous residency training, and review of AHCPR guidelines.