A new study suggests that one of the key reasons few patients who need implantable defibrillators get them is that primary care doctors often don't know when to recommend them. Right now, between 300,000 and 400,000 Americans per year suffer a sudden cardiac attack, most of which are caused by an electrical disturbance. However, some studies have shown that as many as 80 percent of patients who meet guidelines for having an ICD implanted aren't getting them.
To figure out why this is the case, researchers at Cleveland's MetroHealth Medical Center sent out surveys to primary-care physicians in nine northeast Ohio counties, asking them when they might refer a patient for an ICD. The questions were based on CMS's guidelines for ICD use from 2005. When she tallied the responses, researcher Dr. Kara Quan found that only one-quarter to one-third of PCPs responding were aware of referral guidelines for ICDs.
Another factor that emerged--surprisingly--was that 80 percent of PCPs said that patients refused to be referred for ICDs. She suspects that patients' refusals may be linked to doctors' lack of knowledge of the guidelines, and poor understanding of the benefits of such a device.
To learn more about the study:
- read this New Orleans Times-Picayune article
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