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UBC Theses and Dissertations

The therapeutic management of HIV disease : concurrence with contemporary clinical guidelines among the physicians of British Columbia Heath, Katherine Valerie


Objectives: To describe patterns of knowledge regarding the therapeutic management of HIV-disease and concordance with therapeutic guidelines among three groups of British Columbian physicians and to identify possible determinants of these patterns Methods: Anonymous questionnaires were mailed to: all registrants of a province-wide HIV/AIDS drug treatment program (Group-G, n=659); all physicians who had a patient test HIV positive since 1989 (Group-H, n=816); and a random sample selected from the remaining physicians of British Columbia (Group-R, n=484). Questionnaires provided information about: physician demographic, personal and professional characteristics; level of current and total HIV-related experience; and knowledge of the use of therapeutic strategies including vaccinations, clinical tests, laboratory tests and antiretroviral therapy in the context of HIV patient care. An extended version of the survey sent to Group-G physicians requested additional information about the management of HIV-related opportunistic infections (OIs). Summary scores of patient care knowledge were computed by comparing physician responses to questions pertaining to knowledge of clinical management with recommendations made in contemporary therapeutic guidelines. Linear regression was used to identify associations between physician characteristics and knowledge scores. Results: Complete information was received from 38% of G-Group and 50% of Groups H and R, with limited demographic and experiential information obtained from a further 27%, 18% and 20% of groups G, H and R respectively. Multivariate analysis revealed a significant inverse relationship between physician knowledge and age in all groups (all p

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