Physician specialty is associated with differences in warfarin use for atrial fibrillation

OBJECTIVE: To determine whether physician specialty is associated with prescription of warfarin to elderly persons with atrial fibrillation. DESIGN: Cross sectional survey. SETTING: One hundred and thirty-eight randomly selected general practitioners - all 58 internists and all 27 cardiologists in southern Alberta were surveyed by mail. INTERVENTION: Physicians identified their preferred drug for stroke prevention generally and in response to two hypothetical cases. MAIN RESULTS: Response rates were 66% (general practitioners), 76% (internists) and 89% (cardiologists). Specialists (92%) were more likely than general practitioners (76%) to choose warfarin (P=0.007). Findings were similar for questions related to case scenarios; however, the magnitude of differences between specialists and general practitioners was less pronounced. Specialists were more likely (77%) to prescribe warfarin for elderly females than were general practitioners (62%, P=0.08). Similar proportions of specialists (77%) and general practitioners (67%) would prescribe warfarin to elderly males. CONCLUSION: Physician speciality is associated with warfarin prescription for elderly persons with atrial fibrillation.