P R Gully1, D C Fisher, R Pless, C Herbert. 1. Bureau of Communicable Disease Epidemiology, Health Canada's Laboratory Centre for Disease Control, Ottawa.
Abstract
OBJECTIVE: To identify gaps in knowledge about sexually transmitted diseases (STDs) and evaluate practice. DESIGN: We compared how 49 family physicians managed 249 episodes of STDs with the recommendations of the 1988-1989 Canadian STD management guidelines. (The study took place before revised guidelines were distributed in late 1992.) SETTING: Family physicians' practices throughout Canada. PARTICIPANTS: Physicians recruited by the National Research System from among the members of the College of Family Physicians of Canada. These physicians had been in practice for a mean of 9 years; 43 were Certificants of the College. MAIN OUTCOME MEASURES: Family physicians' self-reported episodes of sexually transmitted disease evaluated in light of current Canadian guidelines. RESULTS: Of the 249 episodes studied, 215 (86.3%) were treated effectively, and 34 (13.7%) were judged to have been treated ineffectively. Of the 215 effective treatments, 67 (31.2%) were not completely in agreement with current guidelines. CONCLUSION: Experienced family physicians with postgraduate training usually manage STDs well. The number of ineffective treatments and effective treatments not following the 1988-1989 guidelines, especially for pelvic inflammatory disease, indicates that information on managing certain STDs and syndromes should be made available to all family physicians in a format that is easy to read and use.
OBJECTIVE: To identify gaps in knowledge about sexually transmitted diseases (STDs) and evaluate practice. DESIGN: We compared how 49 family physicians managed 249 episodes of STDs with the recommendations of the 1988-1989 Canadian STD management guidelines. (The study took place before revised guidelines were distributed in late 1992.) SETTING: Family physicians' practices throughout Canada. PARTICIPANTS: Physicians recruited by the National Research System from among the members of the College of Family Physicians of Canada. These physicians had been in practice for a mean of 9 years; 43 were Certificants of the College. MAIN OUTCOME MEASURES: Family physicians' self-reported episodes of sexually transmitted disease evaluated in light of current Canadian guidelines. RESULTS: Of the 249 episodes studied, 215 (86.3%) were treated effectively, and 34 (13.7%) were judged to have been treated ineffectively. Of the 215 effective treatments, 67 (31.2%) were not completely in agreement with current guidelines. CONCLUSION: Experienced family physicians with postgraduate training usually manage STDs well. The number of ineffective treatments and effective treatments not following the 1988-1989 guidelines, especially for pelvic inflammatory disease, indicates that information on managing certain STDs and syndromes should be made available to all family physicians in a format that is easy to read and use.