Family medicine physician teachers and residents’ intentions to prescribe and interpret spirometry: a descriptive cross-sectional study

Abstract

Background: Spirometry is the best test to demonstrate airway obstruction, but remains underused in primary care. Objectives: We assessed, among family medicine physician teachers and residents, their intention to prescribe spirometry in patients suspected of chronic obstructive pulmonary disease and their intention to interpret the results. This evaluation is based on the theoretical framework proposed by Godin et al. for the study of factors influencing healthcare professionals’ behavior. Methods: Participants of this descriptive cross-sectional study were recruited from eight Family medicine units (FMUs) of Laval University’s network. They completed a 23-item self-administered questionnaire measuring their intention to prescribe and to interpret spirometry as well as some determinants of this intention (beliefs about capabilities, beliefs about consequences, social influence and moral norm). Answers to each of the items were scored on a Likert scale (score 1 to 7) where a higher score indicated a greater agreement with the statement. Results: Of the 284 eligible physicians, 104 were included. The mean score ± standard deviation of physicians' intention to prescribe spirometry (6.6 ± 0.7) was higher than to interpret the results (5.8 ± 1.5). Mean scores for all determinants of intention measured were also higher for prescription than for interpretation of spirometry. Conclusion: The results suggest that participants have a very strong intention to prescribe spirometry. Although the intention to interpret the results is positive, it is weaker than for the prescription of the test. Further studies will be needed to assess the barriers to spirometry interpretation.

Keywords:

• Spirometry
• chronic obstructive pulmonary disease
• family medicine physician teachers
• family medicine residents
• prescription
• interpretation

Acknowledgments

The authors would like to acknowledge Julie Turmel, Ph.D. for help with the project and for commenting on the manuscript, Françoise Proust for her help with the protocol and Serge Simard for assistance with data analysis. We are grateful to Dre France Légaré, B.Sc. Arch, M.D., Ph.D., C.C.F.P., F.C.F.P. for her suggestions about the protocol and her help with the CPD-Reaction questionnaire and Adriana Freitas, Ph.D. for her time answering questions also about the CPD-Reaction questionnaire. We would like to thank Justine Veilleux and Geneviève Lortie for their help in data entry and files management. Finally, we are very grateful to family medicine physician teachers and residents who gave up their time to participate in the study.

Disclosure Statement

Potential conflicts of interest to disclose is the Knowledge Translation, Education and Prevention Chair in Respiratory and Cardiovascular Health is supported by unrestricted grants from AstraZeneca. A. D., M.-È. B., M. G. and M. S. have no conflict of interest to declare. L.P. B. considers having no conflict of interest in regard to this study. The authors alone are responsible for the content and writing of this paper.

Contributions

Substantial contributions to the conception or design of the work; or the acquisition of the work; or the analysis, or interpretation of data for the work: A. D.; M.-È. B.; M. G.; M. S.; L.-P. B. Drafting the work: A. D. Revising the work critically for important intellectual content: A. D.; M.-È. B.; M. G.; M. S.; L.-P. B. Final approval of the version to be published: A. D.; M.-È. B.; M. G.; M. S.; L.-P. B. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: A. D.; M.-È. B.; M. G.; L.-P. B.; M. S.

Additional information

Funding

This project was funded by the Knowledge Translation, Education and Prevention Chair in Respiratory and Cardiovascular Health, which received a grant from Novartis and Boehringer Ingelheim for funding the development of an interactive mobile application to help with the prescription and interpretation of spirometry testing (SPIRO^©).