The University of Southampton
University of Southampton Institutional Repository

Which doctors are influenced by a patient's age? A multi-method study of angina treatment in general practice, cardiology and gerontology

Harries, Clare, Forrest, Damien, Harvey, Nigel, McClelland, Alastair and Bowling, Ann (2007) Which doctors are influenced by a patient's age? A multi-method study of angina treatment in general practice, cardiology and gerontology Quality and Safety in Health Care, 16, (1), 23 - 27. (doi:10.1136/qshc.2006.018036). (PMID:17301199).

Record type: Article


Background: Elderly patients with cardiovascular disease are relatively undertreated and undertested.
Objectives: To investigate whether, and how, individual doctors are influenced by a patient's age in their investigation and treatment of angina.
Design: Process-based judgment analysis using electronic patients, semistructured interviews.
Setting: Primary Care, Care of the Elderly and Cardiology in England.
Participants: Eighty five doctors: 29 cardiologists, 28 care of the elderly specialists and 28 general practitioners (GPs).
Main outcome measures: Testing and treatment decisions on hypothetical patients.
Results: Forty six per cent of GPs and care of the elderly doctors, and 48% of cardiologists treated patients aged 65+ differently to those under 65, independent of comorbidity. This effect was evident on several decisions: elderly patients were less likely to be prescribed a statin given a cholesterol test, referred to a cardiologist, given an exercise tolerance test, angiography and revascularisation; more likely to have their current prescriptions changed and to be given a follow-up appointment. There was no effect of specialty, gender or years of training on influence of patient age. Those doctors who were influenced by age were on average five years older than those who were not. Interviews revealed that some doctors saw old age as a contraindication to treat.
Conclusions: Age, independent of comorbidity, presentation and patients' wishes, directly influenced decision-making about angina investigation and treatment by half of the doctors in the primary and secondary care samples. Doctors explicitly reasoned about the direct influence of age and age-associated influences.

Full text not available from this repository.

More information

Published date: February 2007
Keywords: acute myocardial infarction, coronary heart disease, secondary prevention, management, sex, surgery, race
Organisations: Faculty of Health Sciences


Local EPrints ID: 334574
ISSN: 1475-3898
PURE UUID: a6ac6964-3c06-41c3-9d5c-e14c2203c4f2

Catalogue record

Date deposited: 30 Mar 2012 11:33
Last modified: 18 Jul 2017 06:11

Export record



Author: Clare Harries
Author: Damien Forrest
Author: Nigel Harvey
Author: Alastair McClelland
Author: Ann Bowling

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton:

ePrints Soton supports OAI 2.0 with a base URL of

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.