Knowledge of chronic stable coronary artery disease management among general practitioners in Shanghai Pudong New Area / 中华全科医师杂志

ABSTRACT

Objective To survey the knowledge of chronic stable coronary artery disease management among general practitioners (GPs) in Shanghai Pudong New Area.Methods The survey was conducted among 363 GPs with at least 2-year work experiences from community health service centers in Shanghai Pudong New Area from July to September in 2014.A self-designed questionnaire based on the guidelines/consensus of chronic stable coronary artery disease management were used in the survey.The questionnaire consisted of 4 partsdiagnosis,drug therapy,revascularization and treatment of special types.Results Among 363 participants 362 questionnaires were completed.History taking,physical examination and electrocardiogram were applied for diagnosis in all participants,49.2％ (178/362) also used coronary computed tomography angiography,26.5％ (96/362)used exercise testing for assistant examination.More than 95.0％ of participants recognized that smoking,obesity,hyperlipidemia,hypertension,diabetes were risk factors.75.7％ (274/362) of participants used aspirin,91.4％ (331/362) knew the dose of aspirin as 75-150 mg;for aspirin intolerance 14.6％ (53/362)would use clopidogrel alternatively.50.6％ (183/ 362) of participants sometimes used statins;and 39.2％ (142/362) did not use stain because of not knowing the contraindication.Facing increases of alanine aminotransferase or aspartate aminotransferase levels 95.3％ (345/362) of participants would immediately discontinue stain;80.4％ (291/362) discontinued statins as creatine kinase increased.32.0％ (116/362) of participants gave enough drug-free period avoiding nitrates resistance.79.6％ (288/362) seldom used β-blockers and 42.5％ (154/362) failed to use β-blockers because not knowing the contraindication.78.7％ (285/362) knew percutaneous coronary intervention but did not know its indications;83.1％ (301/362)knew coronary artery bypass but did not know its indications.27.6％ (100/362) knew calcium antagonists were first-line drugs for variant angina and 93.6％ (339/362) never heard of microvascular angina.Conclusion The survey shows that GPs from community health service centers in Shanghai Pudong are not well familiar with examination of coronary heart disease and lack of sufficient knowledge of drugs recommended by the guideline,not well understand the indications for revascularization and the diagnosis and treatment of special types of coronary heart disease.