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The Journal of the American Board of Family Medicine 19:459-467 (2006)
© 2006 American Board of Family Medicine

Original Research

The Fish in Secondary Prevention of Heart Disease (FISH) Survey—Primary Care Physicians and {omega}3 Fatty Acid Prescribing Behaviors

Robert C. Oh, MD, MPH, Shirley A. A. Beresford, PhD and William E. Lafferty, MD

Tripler Army Medical Center, Honolulu, HI (RCO)
University of Washington School of Public Health and Community Medicine, Seattle, WA (SAAB, WEL)

Correspondence: Corresponding author: Robert C. Oh, MD, MPH, 3054 Ala Poha Place #2101, Honolulu, HI 96818 (E-mail: roboh98{at}gmail.com)

Purpose: Consumption of fish oil has been shown to reduce mortality in patients with cardiovascular disease (CVD). This study aims to determine the frequency and associations of dietary fish prescribing by family physicians.

Methods: A 22-item survey mailed to randomly selected Washington State family physicians.

Results: Nearly all agreed that nutrition is important in CVD prevention (99%) and felt that they have an essential role in giving dietary advice (92%). The majority (57%) knew of fish oil’s effectiveness in secondary prevention of CVD. However, only 17% of respondents were identified as high fish prescribers. Knowledge of fish oil’s benefit in sudden death reduction was associated with higher fish prescribers in bivariate (P = .005) and multivariate analysis (OR = 2.77; 95th CI: 1.32 to 5.82). High fish prescribers were more likely to report having sufficient time to discuss dietary therapies in bivariate (P = .018) and multivariate analysis (OR = 1.43; 95th CI: 1.03 to 1.98).

Conclusions: Despite knowledge of fish oil’s benefit and favorable attitudes toward nutritional therapy, family physicians infrequently recommend fish oils for their CVD patients. Strategies improving awareness of fish oil’s effects on sudden death and reducing time barriers associated with dietary counseling should be explored further to increase recommendation of this important advice.


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