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Dec 13, 2016Keywords:
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Awareness and attitudes towards total cardiovascular disease risk assessment in clinical practice among physicians in Southern Nigeria
Abstract
Introduction: The disparity between the increasing burden of cardiovascular disease (CVD) and available resources to treat it in sub-Saharan Africa necessitates preventive strategies. Total CVD risk assessment is a cost-effective approach to guide primary preventive therapy. However, in order to utilise this approach there has to be an understanding about it among the end-users. The objective of this study was to determine the awareness, use, and attitudes regarding total CVD risk assessment in clinical practice among physicians in Port Harcourt, Nigeria.
Methods: a cross-sectional survey of 150 physicians in government hospitals and private practices in Port Harcourt city. The characteristics of ‘users’ versus ‘non-users’ of CVD risk assessment were compared with the Chi-Square test of significance.
Results: 106 physicians completed the questionnaires. 74 (69.8%) reported awareness of tools available to assess total CVD risk. Among those aware, 87.1% agreed that CVD risk assessment is useful, 81% agreed it improves patient care, 74.3% agreed it leads to better decisions about recommending preventive therapies and 60% agreed that it increased the likelihood that they would recommend risk-reducing therapies to high-risk patients. However, 62.9% of these physicians felt it was time-wasting to use and only 21 (28.4%) actually use CVD risk assessment regularly in practice. The most commonly reported barrier was unfamiliarity with how to use risk estimation tools (52.8%). Majority who use it do so to guide preventive therapy. Female sex and the use of an Internet-enabled smartphone were associated with increased odds of being a ‘user’ of risk estimation tools (odds ratios 4.8, CI 1.4-16.9; and 5.9, CI 1.7-20.0 respectively).
Conclusion: Utilisation of risk assessments in clinical practice is low. A major barrier was nonfamiliarity with how to use the tools. Continuous medical education and wider use of smartphone technology may represent health system approaches to tackling this issue.
Keywords: Risk assessment, cardiovascular disease, and primary prevention
