Department of Cardiology, Peking University First Hospital, Xicheng District, Beijing, China.
Eur J Prev Cardiol. 2012 Oct;19(5):991-8. doi: 10.1177/1741826711421299. Epub 2011 Aug 22.
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.
In 2007 a cross-sectional questionnaire survey was conducted among physicians from cardiology departments in 35 tertiary hospitals in China.
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).
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.
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.
在冠心病二级预防中，指南要求与临床实践之间存在差距。医生的意识和熟悉程度对于将这些指南付诸实践至关重要。
2007 年，在中国 35 家三级医院的心脏病学部门的医生中进行了横断面问卷调查。
调查工具包含了确定医生对冠心病二级预防指南建议的知识的问题。这些建议包括血压、血脂异常和糖尿病的治疗目标，生活方式的改变以及二级预防所需的药物。这些标准主要基于 AHA/ACC 对冠心病和动脉粥样硬化血管疾病患者的二级预防指南（2006 年）。
认为来自 837 名医生的答复有效并进行了分析。对血压、LDL 和 HbA1c 的治疗目标的了解程度分别为 80.8%、84.2%和 36.2%；然而，只有 27.5%的医生正确选择了所有三个目标。医生对生活方式的改变了解甚少，因为只有 2.3%的医生正确回答了关于饮食治疗和有氧运动目标和要求的五个问题。关于与药物相关的六个基本问题，87%的医生回答正确。一些具体问题的正确率要低得多，这表明医生的知识不精确且不具有时效性。
来自三级医院的这群医生对冠心病二级预防，特别是生活方式的改变的了解较差。必须努力教育医生以提高他们的知识并改善患者的护理。
