A cross sectional study on knowledge, attitudes, and practices of Greek cardiologists towards screening recommendations for cardiovascular diseases

Abstract

As the cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality the need for increased knowledge, awareness and implementation of evidence based guidelines for prevention in clinical practice is increasingly recognized. The aim of this study was to assess Cardiologists knowledge, attitudes and practices toward screening for cardiovascular diseases. The guidelines of United States Preventive Medicine Task Force (USPSTF) were used as reference. A descriptive cross sectional study in a random sample of Cardiologists was used to assess the Knowledge Attitude and Practices of Greek Cardiologists towards screening for cardiovascular diseases. Data collection through telephone interviews was the method of choice. Participants were queried on socio demographic characteristics, their knowledge and attitudes, regarding screening. Out of 371 Cardiologists invited to participate 297 completed the telephone survey,(response rate: 80%). The data were entered into a database created by the Epi Info software. Statistical software R version 3.2.0 was used to analyze data. Descriptive analysis was initially performed while variables found statistically significant were included in a backward logistic regression model. Latent class analysis was performed in R statistical software version 3.2.0 in order to identify significant risk factors of inappropriate practice regarding knowledge and attitudes towards screening.  More than half of the Cardiologists (53.7 %) failed to screen for abdominal aortic aneurysm(ΑΑΑ) in a man 67 years with smoking history. The vast majority of the Cardiologists were also found to incorrectly offer screening for dyslipidemia in a man 23 years (80%), in a woman 36 years (83.4%) as well as in a woman 46 years old (93.5%). Most of Cardiologists would inappropriately screen for coronary heart disease (CHD) in a man 47 years (83.6%) as well as in a woman 57 years old (82 %). Furthermore, contrary to USPSTF recommendation, the majority of Cardiologists would screen for carotid artery stenosis (CAS) in an obese hypertensive man 53 years old. Our study revealed not only a number of key gaps in knowledge but also certain socio-demographic characteristics that are related to inappropriate practices and attitudes. The present study indicates important opportunities to improve the evidence-based practices of Greek cardiologists towards screening of CVD.

Keywords: Public health, evidence based medicine, screening, Cardiologists, Greece