Healthcare workers’ knowledge, attitudes, and practices towards cardiovascular disease prevention: a multi-national cross-sectional study

Abstract Aims We sought to understand healthcare workers’ (HCW) cardiovascular disease (CVD) prevention knowledge, attitudes, and practices to help inform future healthcare policies and optimize preventive cardiology care. Methods Data was collected via an anonymous, online questionnaire which consisted of pre-validated CVD prevention and smoking cessation scales adapted from the Preventive Medicine Attitudes and Activities Questionnaire. Results Six hundred sixty-eight HCWs (60.5% doctors, 27.8% nurses, 11.7% medical students) from 25 nations responded to the survey. Overall, 74.9% of HCWs routinely assessed patients’ cardiovascular risk profiles in clinical practice. About 65.7% of HCWs counselled patients who were asymptomatic for CVD on tangible lifestyle changes to improve their cardiovascular risk profiles, while 68.2% of HCWs did so when patients were overweight. Of note, only 51.3% of HCWs implemented comprehensive smoking cessation interventions for their patients. Practising HCWs demonstrated higher levels of CVD prevention promotion than medical students in all aspects, except for self-reported importance of CVD risk factor counselling (Tukey honestly significant difference diff: 0.31, P-value: .051). Among practising HCWs, there were no significant differences in their CVD prevention practices across varying lengths of clinical practice. HCWs from higher income nations tended to fare worse than their lower income counterparts. Conclusion A large multi-national survey reveals significant gaps in the promotion of CVD prevention by HCWs. Significant differences between medical students and practising HCWs’ CVD prevention behaviours, highlight the role of education for the promotion of long-term positive CVD prevention practices. Further efforts should target the medical education of early-career HCWs, especially in higher income nations. Key message What is already known on this topic: The importance of lifestyle modification for the primordial prevention (risk factor prevention) and primary prevention (risk factor management) of cardiovascular disease (CVD) is indisputable. Studies have shown that physicians and other healthcare workers (HCWs) may be best placed to encourage tangible lifestyle changes and enact meaningful modification in patients’ cardiovascular health-related behaviours. What this study adds: However, in practice, the role of HCWs in monitoring and encouraging patients’ health behaviours is complicated by the challenges of real-life clinical practice, such as time constraints or lack of manpower. Hence, this large multi-national survey sought to understand HCWs’ CVD prevention knowledge, attitudes, and practices to help inform future healthcare policies and optimize preventive cardiology care. How this study might affect research, practice, or policy: This study reveals significant gaps in the promotion of CVD prevention by HCWs, highlighting key differences in CVD prevention practices based on profession, level of training, subspecialty, and national income status. Nurses, cardiology subspecialists, and HCWs from lower middle-income nations were found to be more proficient in promoting CVD prevention compared to their counterparts. Further efforts should target the medical education of undergraduate HCWs, especially in higher income nations, as established clinical practices learned during clinical education typically persist and are resistant to change over time.