Barriers and facilitators to the prescription of automated external defibrillators for home use in patients with heart disease: a survey of cardiologists.

OBJECTIVE: Because the majority of cardiac arrests occur at home, the use of automated external defibrillators (AEDs) in the home could potentially improve survival of out-of-hospital cardiac arrest. Currently, physicians must prescribe AEDs for home use by patients. The purpose of this study was to investigate the barriers and facilitators to prescription of home use of AEDs. DESIGN: Telephone interviews were conducted with 85 cardiologists and paper and pencil surveys (via fax) with 59 additional cardiologists in Washington State. OUTCOME MEASURES: Cardiologists were asked about their current practices and their perceived barriers and facilitators to prescription of AEDs for home use. RESULTS: Eighty-five percent of the sample believed that AEDs could be effective in preventing death, although only 7% of the cardiologists had ever prescribed an AED. Reasons for nonprescription included the use of implantable cardioverter defibrillators, perceived lack of a clear patient niche, and lack of knowledge about the device. The majority of respondents reported that they would be more likely to prescribe AEDs if they were the standard of care (71%), were covered by insurance (67%), and came with comprehensive training (58%). CONCLUSION: The results showed that cardiologists believe that home use of AEDs can be effective but that many issues regarding the prescription of AEDs remain.