Physician survey assessing pelvic inflammatory disease knowledge and attitudes to identify diagnosing and reporting barriers

Background:  Pelvic inflammatory disease (PID) is a notifiable disease in Hawaii with legal implications for noncompliance.   Two previous analyses comparing PID diagnoses in Hawaii’s hospitals and Hawaii Department of Health (HDOH) surveillance data, confirmed underreporting in Hawaii. 

Methods: All licensed primary care physicians in Hawaii were mailed a one-page, 20-question survey addressing PID diagnosis and reporting attitudes and practices.  Hierarchical logistic regression was used to determine if physician characteristics, PID knowledge, or attitudes related to the diagnosis or reporting of PID, increased the odds of diagnosing and reporting PID.  

Results:  Among survey respondents (486 of 1062; response rate = 45.8%), 104 (21.4%) had diagnosed and 58 (11.9%) had reported a PID case in the past 12 months. About half of physicians agreed that PID reporting was time consuming. In hierarchical regression, those 15-20 years since residency were less likely to report PID than those <15 years since residency, and increased PID diagnosing and reporting knowledge increased the odds of PID reporting by 1.63 times. However, increased PID diagnosing and reporting knowledge and a favorable attitude towards PID diagnosing and reporting did not increase the odds of PID diagnosing. 

Conclusion:  Our findings suggest the need for targeted post-residency continued education of physicians as well as the need to simplify the reporting process. Increased PID-related communication between local health departments and physicians is essential, and physicians should be provided technical assistance with reporting.