When it comes to treating heart conditions, the influence of the age of the doctor involved is not often a consideration.
But an Italian study looking at that parameter has revealed that clinical practice differs subtly between generations, with younger medics more likely to reach for the prescription pad and older doctors more readily suggesting lifestyle changes to patients.
However, these differences in approach did not yield any significant differences in patient outcome. This could be viewed positively – the age of your doctor will not affect whether you get better – or negatively – prescribing drugs is more expensive than encouraging lifestyle change and emphasis on the latter burdens healthcare systems to no appreciable benefit.
The study in question, published in the International Journal of Clinical Practice, looked at the attitudes and prescribing trends of 1,078 GPs, cardiologists and diabetologists in Italy as well as the clinical data of 9,904 of their outpatients. The doctors were blind to the purpose of the study.
Blood pressure drugs, called antihypertensives, were the most commonly prescribed across all age groups but, contrary to clinical recommendations, not all patients with high blood pressure were prescribed medication.
Doctors under the age of 45 were most likely to prescribe antihypertensives than their older colleagues. This trend was repeated for anti-diabetic drugs, lipid-lowering agents like statins and antiplatelet agents that thin the blood.
Yet the younger doctors were significantly less likely to recommend lifestyle changes, like quitting smoking or exercise, to their patients and tended to be less thorough in their note taking.
The difference in approach across generations may have several root causes. Firstly, a higher proportion of the younger doctors were specialists (cardiologists or diabetologists) compared with those over 45. The results may therefore represent a tendency of specialists to prescribe medication at the expense of lifestyle advice.
Alternatively, or perhaps coincidentally, the study may be an indication of a genuine trend in medicine towards drug treatment and away from a more holistic approach. The influence of experience, rather than age, may also be a factor. The younger medics in this study may be more inclined to give lifestyle advice later in their careers as they, too, become more experienced.
Image credit: Andy Woo (Flickr)
Tocci, G., Ferrucci, A., Guida, P., Avogaro, A., Comaschi, M., Corsini, A., Cortese, C., Giorda, C., Manzato, E., Medea, G., Mureddu, G., Riccardi, G., Titta, G., Ventriglia, G., Zito, G., Volpe, M., & , . (2011). Impact of physicians’ age on the clinical management of global cardiovascular risk: analysis of the results of the Evaluation of Final Feasible Effect of Control Training and Ultra Sensitisation Educational Programme International Journal of Clinical Practice, 65 (6), 649-657 DOI: 10.1111/j.1742-1241.2011.02664.x
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