Department of Internal Medicine, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Kispatićeva 12, 10000 Zagreb, Croatia.
Atherosclerosis. 2010 Dec;213(2):598-603. doi: 10.1016/j.atherosclerosis.2010.09.014. Epub 2010 Oct 13.
Cardiovascular diseases (CVD) are the major cause of premature death in the world. This study was designed to examine the physicians' knowledge and perception of CVD risk factors and perceived implementation of CVD prevention guidelines as well as barriers to their implementation.
A questionnaire survey by face-to-face interviews was performed among 1382 randomly selected physicians (general practitioners/family medicine specialists, internists and cardiologists) from different regions of Croatia.
Most physicians believe that guidelines are useful but only 56.9% are really using some guidelines. 40.2% favour Joint European guidelines. More primary care physicians use their own personal experience in prevention while internists and cardiologists tend more to use the guidelines. 80.6% believe that they treat their patients with dyslipidemia well but only 53.3% knew the LDL-cholesterol goal value for high-risk patients and only 56.2% knew which HDL-cholesterol level is the marker of increased risk. Hypertension was perceived as the most important risk factor, particularly by primary care physicians, while cardiologists tend to favour diabetes. Although most physicians considered the lack of financial resources as the main barrier in CVD prevention, at the same time most of them believe that it could primarily be improved by better patient education.
Although most physicians support the guidelines use, only half of them use them and in average their knowledge of guidelines is not satisfactory. This is, together with the lack of time and finances and perceived lack of patients' awareness, probably one of the main causes why they do not manage risk factors better.
心血管疾病(CVD)是世界范围内导致过早死亡的主要原因。本研究旨在调查医生对 CVD 危险因素的知识和认知,以及对 CVD 预防指南的实施情况和实施障碍的看法。
通过面对面访谈,对克罗地亚不同地区的 1382 名随机选择的医生(全科医生/家庭医学专家、内科医生和心脏病专家)进行了问卷调查。
大多数医生认为指南是有用的,但只有 56.9%的医生真正在使用某些指南。40.2%的医生赞成联合欧洲指南。更多的初级保健医生在预防中使用自己的个人经验,而内科医生和心脏病专家则更倾向于使用指南。80.6%的医生认为他们对血脂异常患者的治疗效果良好,但只有 53.3%的医生知道高危患者的 LDL-胆固醇目标值,只有 56.2%的医生知道 HDL-胆固醇水平是增加风险的标志物。高血压被认为是最重要的危险因素,特别是初级保健医生,而心脏病专家则倾向于认为糖尿病是最重要的危险因素。尽管大多数医生认为缺乏资金是 CVD 预防的主要障碍,但同时他们也认为通过更好地对患者进行教育可以主要改善这一状况。
尽管大多数医生支持使用指南,但只有一半的医生在使用指南,而且他们对指南的了解程度并不令人满意。这可能是他们无法更好地管理风险因素的主要原因之一,再加上时间、财力和患者意识方面的不足。