Full Text:   <3102>

CLC number: R541.4

On-line Access: 2024-08-27

Received: 2023-10-17

Revision Accepted: 2024-05-08

Crosschecked: 2012-02-10

Cited: 5

Clicked: 5671

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
Open peer comments

Journal of Zhejiang University SCIENCE B 2012 Vol.13 No.3 P.231-238

http://doi.org/10.1631/jzus.B1100299


Influence of education and working background on physicians’ knowledge of secondary prevention guidelines for coronary heart disease: results from a survey in China


Author(s):  Yan-jun Gong, Tao Hong, Jie Jiang, Rong-hui Yu, Yan Zhang, Zhao-ping Liu, Yong Huo

Affiliation(s):  Department of Cardiology, Peking University First Hospital, Beijing 100034, China

Corresponding email(s):   dr_hongtao@163.com

Key Words:  Coronary heart disease, Secondary prevention, Guidelines, Survey


Share this article to: More <<< Previous Article|

Yan-jun Gong, Tao Hong, Jie Jiang, Rong-hui Yu, Yan Zhang, Zhao-ping Liu, Yong Huo. Influence of education and working background on physicians’ knowledge of secondary prevention guidelines for coronary heart disease: results from a survey in China[J]. Journal of Zhejiang University Science B, 2012, 13(3): 231-238.

@article{title="Influence of education and working background on physicians’ knowledge of secondary prevention guidelines for coronary heart disease: results from a survey in China",
author="Yan-jun Gong, Tao Hong, Jie Jiang, Rong-hui Yu, Yan Zhang, Zhao-ping Liu, Yong Huo",
journal="Journal of Zhejiang University Science B",
volume="13",
number="3",
pages="231-238",
year="2012",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1100299"
}

%0 Journal Article
%T Influence of education and working background on physicians’ knowledge of secondary prevention guidelines for coronary heart disease: results from a survey in China
%A Yan-jun Gong
%A Tao Hong
%A Jie Jiang
%A Rong-hui Yu
%A Yan Zhang
%A Zhao-ping Liu
%A Yong Huo
%J Journal of Zhejiang University SCIENCE B
%V 13
%N 3
%P 231-238
%@ 1673-1581
%D 2012
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1100299

TY - JOUR
T1 - Influence of education and working background on physicians’ knowledge of secondary prevention guidelines for coronary heart disease: results from a survey in China
A1 - Yan-jun Gong
A1 - Tao Hong
A1 - Jie Jiang
A1 - Rong-hui Yu
A1 - Yan Zhang
A1 - Zhao-ping Liu
A1 - Yong Huo
J0 - Journal of Zhejiang University Science B
VL - 13
IS - 3
SP - 231
EP - 238
%@ 1673-1581
Y1 - 2012
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1100299


Abstract: 
Background and objective: In clinical practice, the standard of secondary prevention for coronary heart disease (CHD) is quite disappointing in China. The physicians’ shortage of knowledge of secondary prevention guidelines is thought to be a key factor contributing to the inadequate and delayed translation of guidelines into clinical practice. The purpose of this study is to investigate the influence of physicians’ characteristics, including their education and work experience, on their knowledge of secondary prevention in China. Methods: A representative questionnaire survey was made of physicians from cardiology departments in 35 tertiary hospitals in China. The survey contained 19 questions on knowledge of guideline recommendations for the secondary prevention of CHD. We collected basic information about the physicians, including their educational degree, clinical practice duration/work experience and geographic region. Results: In total, 864 physicians participated in the survey. Eight hundred and thirty-seven completed questionnaires were analyzed. For 6 of the 19 questions, physicians with a postgraduate degree were more likely to answer correctly than those without such a degree. For 11 of the 19 questions, physicians with more than three years’ clinical experience were more likely to answer correctly than those who had less than three years’ experience. For 5 of the 19 questions, physicians from eastern areas were more likely to answer correctly than those from mid/western areas. The mean total score of correct answers to the questionnaire was 11.69 points. Educational degree and clinical practice duration affected total scores significantly while practice location did not (β=0.500, P=0.004; β=0.979, P=0.000; and β=0.228, P=0.162, respectively). Even if a relatively low score of 12 is taken as a threshold level of acceptable knowledge (defined as a pass), the pass rate of all physicians was only 53.9%. Educational degree and clinical practice duration affected pass rate significantly while practice location did not (95% CI: 1.222–2.248, P=0.001; 95% CI: 1.773–3.140, P=0.000; and 95% CI: 0.993–1.758, P=0.056, respectively). Conclusions: Physicians with a clinical practice duration of more than three years knew more about secondary prevention guidelines than those with less experience. Physicians with a postgraduate degree knew more about secondary prevention guidelines than those without a postgraduate degree. However, overall knowledge of secondary prevention guidelines for CHD was poor among this group of physicians from tertiary hospitals.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Browner, W.S., Baron, R.B., Solkowitz, S., Adler, L.J., Gullion, D.S., 1994. Physician management of hypercholesterolemia. A randomized trial of continuing medical education. Western J. Med., 161(6):572-578.

[2]Burnier, M., 2002. Blood pressure control and the implementation of guidelines in clinical practice: can we fill the gap? J. Hypertens., 20(7):1251-1253.

[3]Cabana, M.D., Rand, C.S., Powe, N.R., Wu, A.W., Wilson, M.H., Abboud, P.A., Rubin, H.R., 1999. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA, 282(15):1458-1465.

[4]Cheng, Y.Z., Wu, X.G., Huang, W., Qi, G.Q., Gu, D.F., 2002. Physicians’ awareness of “the Guidelines for Prevention and Treatment of Hypertension in China”. Chin. J. Hypertens., 10(2):176-177 (in Chinese).

[5]Cricelli, I., 2006. Use of personal digital assistant devices in order to access, consult and apply a corpus of clinical guidelines and decision-based support documentation like the Italian SPREAD Guidelines on stroke disease. Neurol. Sci., 27(s3):S238-S239.

[6]Cuspidi, C., Michev, I., Meani, S., Severgnini, B., Sala, C., Salerno, M., Valerio, C., Bertazzoli, G., Leonetti, G., Magrini, F., et al., 2003. Awareness of hypertension guidelines in primary care: results of a regionwide survey in Italy. J. Hum. Hypertens., 17(8):541-547.

[7]EUROASPIRE Study Group, 1997. EUROASPIRE. A European Society of Cardiology survey of secondary prevention of coronary heart disease: principal results. Eur. Heart J., 18(10):1569-1582.

[8]Fox, K.A., Goodman, S.G., Klein, W., Brieger, D., Steg, P.G., Dabbous, O., Avezum, A., 2002. Management of acute coronary syndromes. Variations in practice and outcome; findings from the Global Registry of Acute Coronary Events (GRACE). Eur. Heart J., 23(15):1177-1189.

[9]Hagemeister, J., Schneider, C.A., Barabas, S., Schadt, R., Wassmer, G., Mager, G., Pfaff, H., Höpp, H.W., 2001. Hypertension guidelines and their limitations—the impact of physicians’ compliance as evaluated by guideline awareness. J. Hypertens., 19(11):2079-2086.

[10]Jiang, L.X., Chen, Z.M., Xie, J.X., Rory, C., Richard, P., Liu, L.S., 2002. Survey of hospital management of myocardial infarction in China. J. Clin. Cardiol., 18(9):417-420 (in Chinese).

[11]Kho, A., Henderson, L.E., Dressler, D.D., Kripalani, S., 2006. Use of handheld computers in medical education. A systematic review. J. Gen. Intern. Med., 21(5):531-537.

[12]LaBresh, K.A., Ellrodt, A.G., Gliklich, R., Liljestrand, J., Peto, R., 2004. Get with the guidelines for cardiovascular secondary prevention: pilot results. Arch. Intern. Med., 164(2):203-209.

[13]Liu, J., Zhao, D., Liu, Q., Wang, W., Sun, J.Y., Wang, M., Suo, M., 2008. Treatment and control status of hypertension among acute coronary syndrome patients in Chinese multi-centers. Chin. J. Hypertens., 16(1):16-20 (in Chinese).

[14]Marques-Vidal, P., Tuomilehto, J., 1997. Hypertension awareness, treatment and control in the community: is the rule of halves still valid? J. Hum. Hypertens., 11(4):213-220.

[15]McGlynn, E.A., Asch, S.M., Adams, J., Keesey, J., Hicks, J., DeCristofaro, A., Kerr, E.A., 2003. The quality of health care delivered to adults in the United States. N. Engl. J. Med., 348(26):2635-2645.

[16]National Center for Cardiovascular Diseases, 2009. Report on Cardiovascular Diseases in China (2008-2009). Encyclopedia of China Publishing House, Beijing, China (in Chinese).

[17]Niu, S., Zhao, D., Zhu, J., Liu, J., Liu, Q., Liu, J., Wang, W., Smith, S.C.Jr., BRIG Project, 2009. The association between socioeconomic status of high-risk patients with coronary heart disease and the treatment rates of evidence-based medicine for coronary heart disease secondary prevention in China: results from the Bridging the Gap on CHD Secondary Prevention in China (BRIG) Project. Am. Heart J., 157(4):709-715.e1.

[18]Price, M., 2005. Can hand-held computers improve adherence to guidelines? A (Palm) Pilot study of family doctors in British Columbia. Can. Fam. Phys., 51:1506-1507.

[19]Roger, V.L., Go, A.S., Lloyd-Jones, D.M., Adams, R.J., Berry, J.D., Brown, T.M., Carnethon, M.R., Dai, S., de Simone, G., Ford, E.S., et al., 2011. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation, 123(4):e18-e209.

[20]Sharma, K.K., Gupta, R., Agrawal, A., Roy, S., Kasliwal, A., Bana, A., Tongia, R.K., Deedwania, P.C., 2009. Low use of statins and other coronary secondary prevention therapies in primary and secondary care in India. Vasc. Health Risk Manag., 5:1007-1014.

[21]Smith, S.C.Jr., Allen, J., Blair, S.N., Bonow, R.O., Brass, L.M., Fonarow, G.C., Grundy, S.M., Hiratzka, L., Jones, D., Krumholz, H.M., et al., 2006. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation, 113(19):2363-2372.

[22]Wang, W., Zhao, D., Yao, L., Zhou, M.R., Wu, Z.S., 2000. Population based epidemiological study for case fatality of acute coronary events in Beijing. Chin. J. Cardiol., 28(3):228-230 (in Chinese).

[23]Wu, A.H., Parsons, L., Every, N.R., Bates, E.R., Second National Registry of Myocardial Infarction, 2002. Hospital outcomes in patients presenting with congestive heart failure complicating acute myocardial infarction: a report from the Second National Registry of Myocardial Infarction (NRMI-2). J. Am. Coll. Cardiol., 40(8):1389-1394.

[24]Zhao, W., Gao, W., Wang, G.S., 2007. A survey on cardiologists’ knowledge and attitudes towards ST-elevation myocardial infarction guidelines in China. J. Cardiovasc. Pulm. Dis., 26(2):96-99 (in Chinese).

Open peer comments: Debate/Discuss/Question/Opinion

<1>

Please provide your name, email address and a comment





Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2024 Journal of Zhejiang University-SCIENCE