Knowledge of secondary prevention guidelines for coronary heart disease: results from a physicians' survey in China

Background: There is gap between guideline requirements and clinical practice in coronary disease secondary prevention. A physician's awareness and familiarity are essential to put these guidelines in practice. Design: In 2007 a cross-sectional questionnaire survey was conducted among physicians from cardiology departments in 35 tertiary hospitals in China. Methods: The survey instrument contained questions to determine physicians' knowledge of guideline recommendations for coronary heart disease secondary prevention. These included treatment goals for blood pressure, dyslipidaemia and diabetes, lifestyle modifications and medication needs for secondary prevention. The criteria were based mainly on the AHA/ACC Guidelines for Secondary Prevention for Patients with Coronary and Atherosclerotic Vascular Disease (2006). Results: Responses from 837 physicians were deemed effective and were analysed. Knowledge of treatment goals for blood pressure, LDL and HbA1c were 80.8%, 84.2% and 36.2%, respectively; however, only 27.5% of the physicians chose all three goals correctly. Knowledge of lifestyle modification was poor among the physicians as only 2.3% of the physicians correctly answered all five questions about dietary therapy and aerobic exercise goals and requirements. In regard to the six basic questions related to medication, 87% answered correctly. Several specific questions had a much lower rate of being correct, showing that physicians' knowledge was not precise and current. Conclusion: Knowledge of secondary prevention, especially lifestyle modification, for coronary disease was poor among this group of physicians from tertiary hospitals. Efforts must be made to educate physicians to improve their knowledge and improve patient care.