How well do family physicians manage sexually transmitted diseases?

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.