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[Physicians' Adherence to Clinical Guidelines on the Chronic Heart Failure Diagnosis and Treatment: Changes Over 2
N D Perepech1, A V Tregubov1, I E Mikhailova1
1Saint-Petersburg State University.
Insights
Physicians find clinical guidelines (CGs) important for chronic heart failure (CHF) but few know they are mandatory. Cardiologists show better knowledge than internists, yet overall physician understanding of CHF diagnosis and treatment guidelines remains low.
Area of Science:
- Cardiology
- Internal Medicine
- Medical Education
Context:
- Physician adherence to clinical guidelines (CGs) is crucial for effective chronic heart failure (CHF) management.
- Understanding physicians' evolving commitment to CGs over time is essential for improving patient care.
- The study assesses physician knowledge and attitudes towards CHF CGs two years after their introduction.
Purpose:
- To evaluate changes in physicians' commitment to essential provisions of CHF clinical guidelines (CGs).
- To assess physicians' self-reported knowledge and attitudes regarding CHF diagnosis and treatment guidelines.
- To compare the understanding and adherence levels between cardiologists and internists.
Summary:
- A survey of 263 physicians revealed that 60.6% answered questions on CHF treatment correctly, with cardiologists performing better than internists.
- While 71.5% viewed CGs as important, only 26.2% recognized them as mandatory. Cardiologists were more likely to consider CGs mandatory.
- Physician knowledge regarding CHF CGs remains low, despite a noted increase in correct answers among cardiologists compared to 2020.
Impact:
- Highlights a gap in physician awareness regarding the mandatory nature of clinical guidelines for CHF.
- Suggests a need for targeted educational interventions to improve physician understanding and application of CHF guidelines.
- Provides data to inform strategies for enhancing guideline implementation and improving chronic heart failure patient outcomes.
Aim:
To study how physicians' commitment to the basic provisions of clinical guidelines (CGs) for the diagnosis and treatment of chronic heart failure (CHF) has changed over the two years of the document existence.
Material And Methods:
An anonymous survey was performed for 263 physicians (204 cardiologists, 46 internists and 13 other specialists) who were trained in advanced training programs in 2022. The questionnaire included questions regarding self-assessment of the respondents' professional knowledge, their attitude to the role of CGs in everyday practice and ideas about methods for treatment of CHF.
Results:
Respondents gave 60.6 % correct answers to questions related to the treatment of CHF. More than 70% correct answers were given by 42.7% of cardiologists and 17.4% of internists. Compared to 2020, the proportion of cardiologists who gave more than 70 % correct answers increased significantly (p<0.05). CGs were considered mandatory by 26.2% and important or sometimes useful by 71.5% of respondents. Cardiologists considered CGs mandatory more frequently than internists (29.9 and 15.2 %, respectively; p=0.04). The mean number of correct answers was greater in the subgroup of respondents who considered CGs mandatory (p<0.001). More than 70% correct answers were given by only 43.8% of cardiologists, who considered themselves fully informed and able to advise colleagues on complex issues of diagnosis and treatment of CHF, and 40.6% of physicians who considered their knowledge acceptable for managing patients with CHF.
Conclusion:
The majority of physician consider CGs an important methodological document but only a little more than 25 % are aware that CGs are mandatory. Cardiologists are better informed than internists about the principal provisions of National Clinical Guidelines for the diagnosis and treatment of CHF, but the average level of physician knowledge remains low.
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