Lyme disease: knowledge, beliefs, and practices of physicians in a low-endemic area.

OBJECTIVE To determine physicians' level of awareness and knowledge of Lyme disease (LD) in a low-prevalence area and whether physicians' practices align with current guidelines for treatment of LD. DESIGN A 23-item questionnaire assessing demographic characteristics, general knowledge about LD, laboratory testing for LD, and responses to 3 clinical scenarios. SETTING British Columbia (BC). PARTICIPANTS Pediatricians, FPs, and internal medicine specialists who were licensed to practise in BC. MAIN OUTCOME MEASURES Knowledge of signs and symptoms of LD, beliefs about risk of LD, attitudes toward LD in patients in their practices, and application of accepted practice guidelines for the treatment of LD in clinical scenarios. RESULTS Overall, 80.6% of respondents were FPs. Average knowledge score was 72.5% for FPs and 75.0% for other specialists. Most respondents (75.6% of FPs and 71.8% of other specialists) underestimated the occurrence of erythema migrans (EM), and only 26.1% and 28.3%, respectively, knew that EM alone was diagnostic for LD. A total of 30.5% of FPs and 12.1% of other specialists reported having treated a patient for the disease despite not believing that the patient had LD. Of all the respondents, 62.1% knew that LD was a reportable disease in BC. Respondents' reports of risk of LD in their areas were appropriately associated with actual risk based on ecological niche. CONCLUSION Physicians are knowledgeable about the clinical signs and symptoms of LD and aware of the risk of the disease despite being in a low-endemic area. Physicians in BC are comfortable with treating patients empirically for LD. Education is needed to inform physicians that EM is diagnostic and no laboratory testing is indicated before treatment. Raising awareness among physicians that LD is reportable might improve reporting of future cases.