Abstract P312: Impact of Cardiovascular Disease Guideline Dissemination on Provider Knowlege: A Statewide Physician Survey

Objective: We sought to evaluate the presence of a knowledge gap amongst Colorado providers in evidence-based treatment of modifiable CVD risk factors. We wished to identify provider characteristics associated with a larger knowledge gap and we hypothesized that direct dissemination of a CVD/stroke clinical practice guideline (CPG) might narrow the gap. Methods and Analysis: A baseline knowledge survey was distributed to licensed Colorado providers to ensure representation by specialty, provider type, region, population density and years in practice. The CPG was then distributed followed by a repeat knowledge survey to assess proportion reading the guideline and any change in an aggregate knowledge score. We evaluated associations between provider characteristics with CPG review. We then compared pre and post CPG knowledge scores among all respondents, those who read and did not read the guidance. The survey answers were also analyzed to identify specific content areas of CVD knowledge deficits Findings: Of 1415 licensed providers, 59% (830) completed the pre guideline survey, 46% (651) completed the post survey and 37% (523) completed both. The weighted mean of self reported CPG review was 51% (325 of 651, 95% CI 47-55) and was significantly higher amongst mid-level providers (63% vs 44%, p<0.001) than physicians and those in practice greater than 5 years (53% vs 40%, p=0.017). A knowledge deficit was identified in the area of ACE inhibitor use in CKD, post MI, and heart failure patients. Baseline knowledge score was 71% and improved minimally to 72.2% (p=0.038) among those who reviewed the CPG. Conclusions: A significant CVD knowledge gap exists among primary care providers in Colorado, particularly in the use of ACE inhibitors for specific compelling indications. Direct dissemination of our CPG to providers resulted in a high rate of review of the guidance. Midlevel providers and those in practice for > 5 years were more likely to read the CPG. Nonetheless, review of our CPG provided only a small but significant improvement in knowledge, highlighting the need for more robust dissemination and education strategies.