Chronic Disease

Study finds regional differences in physicians’ recommendations of implantable cardioverter-defibrillators

A new study reveals regional differences in physicians’ recommendations of implantable cardioverter-defibrillators (ICDs) for patients considered eligible by current guidelines. It found that physicians in regions with low ICD use were no less likely to recommend ICDs to eligible patients. However, physicians in regions with high ICD use were more likely to recommend the device for patients who may receive limited benefit, such as frail and elderly patients with life expectancies of less than 1 year. Researchers surveyed active members of the American College of Cardiology, with 1,210 responding. Cardiologists were asked to agree or disagree with statements about ICD use and costs, ability to enable the patient to live longer, improved/decreased quality of life, and recommending ICDs to all eligible patients.

Regardless of region, respondents were likely to agree that an ICD enables a patient to live longer. They were also likely to recommend an ICD to patients who meet eligibility guidelines. The study was supported in part by the Agency for Healthcare Research and Quality (HS16964). See "Regional variations in physicians’ attitudes and recommendations surrounding implantable cardioverter-defibrillators," by Dan D. Matlock, M.D., Jean S. Kutner, M.D., M.S.P.H., Caroline B. Emsermann, M.S., and others in the April 2011 Journal of Cardiac Failure 17(4), pp. 318-324.

Research Activities, November 2011: Chronic Disease: Study finds regional differences in physicians’ recommendations of implantable cardioverter-defibrillators