Knowledge assessment regarding secondary prevention of coronary heart disease--a multi centre survey.

Background: Cardiovascular Disease (CVD) is a major cause of mortality worldwide. Control and reduction of cardiovascular risk factors such as elevated blood pressure, high cholesterol levels, excess of body weight, smoking and lack of exercise can contribute to a reduction of CVD mortality.

Methods: A standardized questionnaire was administered to all medical officers willing to participate in the study, who were working in the Cardiology Units all over Sri Lanka to assess the source of continuous medical education, attitudes on secondary prevention, barriers to secondary prevention and knowledge assessment of secondary prevention of cardiovascular diseases. Chi square was used to compare groups and p < 0.05 was considered significant.

Results: 132 participants with equal numbers of males and female doctors participated. While 56 doctors have had no training in cardiology, 75 doctors have had some training in a cardiology unit. The barriers for secondary prevention were, poor knowledge/understanding of patients 3.82 (1.06), too many drugs 3.74 (0.98), presence of co-morbid conditions 3.68(0.97), cost of medications 3.69 (0.97) and poor adherence to prevention strategies by patients 3.44 (1.15). Routine clinic visits 85 (65%) and public awareness day seminars 30 (22.2%) were the most effective methods of secondary prevention. Guidelines were the most popular method of continuous medical education. Those who have had some training in cardiology did not differ in their knowledge from those who have never had training in cardiology. Knowledge about prevention with regard to diet was inadequate and exercise and lipids were adequate but not good. Rates of knowledge on smoking cessation were much higher than for other CVD risk factors.

Conclusion: There needs to be more adherences to clinical guidelines and attention paid to CVD prevention, in particular, the importance of dietary modifications, adequate exercise, and lipid control.