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Physician attitude, awareness, and knowledge regarding guidelines for transcranial Doppler screening in sickle cell disease.

  • Author(s): Reeves, Sarah L
  • Fullerton, Heather J
  • Dombkowski, Kevin J
  • Boulton, Matthew L
  • Braun, Thomas M
  • Lisabeth, Lynda D
  • et al.
Abstract

We explored factors that may influence physician adherence to transcranial Doppler (TCD) screening guidelines among children with sickle cell disease.Pediatric hematologists, neurologists, and primary care physicians (n = 706) responded to a mailed survey in May 2012 exploring factors hypothesized to influence physician adherence to TCD screening guidelines: physician (internal) barriers and physician-perceived external barriers. Responses were compared by specialty using chi-square tests.Among 276 physicians (44%), 141 currently treated children with sickle cell disease; 72% recommend screening. Most primary care physicians (66%) did not feel well informed regarding TCD guidelines, in contrast to neurologists (25%) and hematologists (6%, P < .0001). Proportion of correct answers on knowledge questions was low (13%-35%). Distance to a vascular laboratory and low patient adherence were external barriers to receipt of TCD screening.Additional research regarding physicians' lack of self-efficacy and knowledge of recommendations could help clarify their role in recommendation of TCD screening.

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