Doctor's attitude to administration of statins for primary prevention of cardiovascular diseases

Перепеч, Н. Б.; Tregubov, A. V.

doi:10.18087/rhj.2017.1.2301

RHJ

2017

DOI: 10.18087/rhj.2017.1.2301

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Doctor's attitude to administration of statins for primary prevention of cardiovascular diseases

Н. Б. Перепеч¹,

A. V. Tregubov²

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Cited by 2 publications

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“…-acceleration of the process of improving diagnostic methods and treatment of diseases and, accordingly, the rapid obsolescence of the knowledge of medical workers; -strengthening the role of clinical guidelines of the Ministry of Health (MH) of the Russian Federation as regulatory documents 3 ; -the need to form an individual plan for advanced training for each medical worker, taking into account his tasks and the level of professional skills [1]; -widespread introduction of distance learning technologies, which has gained particular importance in the context of the COVID-19 pandemic [2]. A prerequisite for achieving and maintaining a high qualification level of a modern doctor is his participation in the system of continuing medical education (CME).…”

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confidence: 99%

“…Available at: http:// www.kremlin.ru/acts/bank/43027 (accessed: 12.12.2021). (In Russian) 3 Federal'nyi zakon ot 25 dekabrya 2018 g. N 489-FZ "O vnesenii izmenenii v stat'yu 40 Federal'nogo zakona 'Ob obyazatel'nom meditsinskom strakhovanii v Rossiiskoi Federatsii' i Federal'nyi zakon 'Ob osnovakh okhrany zdorov'ya grazhdan v Rossiiskoi Federatsii' po voprosam klinicheskikh rekomendatsii": ofits. tekst.…”

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confidence: 99%

“…As a result of this work, a number of aspects have been identified that require more detailed discussion in the framework of professional development programs for doctors. For example, it was found that physicians in a significant proportion of cases have a misconception about the target levels of lipids and the critical levels of therapy safety indicators, the achievement of which is considered a criterion for interrupting or stopping statin therapy, and also often show excessive alertness about the risk of statins' side effects development [3]. In order to eliminate these shortcomings in the training of doctors, a labor intensity of 36 hours advanced training program "Correction of Dyslipidemia in Patients with Resistance and Poor Tolerance to Lipid-Lowering Therapy" was developed and implemented.…”

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Methodological aspects of programs’ updating for advanced training of doctors

Tregubov

Shurygina²,

Перепеч³

2021

Vestnik SPbSU. Medicine

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An important component of improving the healthcare system is providing medical institutions with highly qualified personnel. In the era of evidence-based medicine, clinical guidelines developed by the expert community and approved by regulatory authorities are the cornerstone of maintaining the knowledge and skills of medical personnel at a high level. In modern medicine, new data are accumulating very quickly, which requires regular changes in the algorithms for managing specialized patients. Frequent updating of clinical guidelines and their increasing importance as a document regulating the provision of medical care to patients with various diseases necessitate the intensification of additional professional education of doctors. Doctors’ awareness of the current provisions of clinical guidelines and readiness to implement them in everyday practice is an important condition for the compliance of real medical care with modern requirements. Under the conditions of the system of continuous medical education, the programs for improving the skills of doctors should be constantly improved. The article discusses the methodology for updating educational programs based on the analysis of the results of an anonymous survey of doctors on the main aspects of the current clinical guidelines. Identification of questions, the answers to which turn out to be incorrect more often than others, and quantitative analysis of the distribution of incorrect answers allow to correct programs in order to achieve a higher level of knowledge of trainees in the most difficult sections of clinical guidelines. Information about the changes that were made to the advanced training programs for doctors in the diagnosis and treatment of cardiovascular diseases on the basis of the data obtained during the questionnaire is presented. It is expected that the discussed methodology for updating the advanced training programs for doctors will help to improve the provision of the needs of modern healthcare for highly qualified personnel.

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confidence: 99%

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Methodological aspects of programs’ updating for advanced training of doctors

Tregubov

Shurygina²,

Перепеч³

2021

Vestnik SPbSU. Medicine

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Physicians’ adherence to the guidelines on the chronic heart failure diagnosis and treatment

Перепеч

Mikhailova

2022

Kardiologiia

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Aim To evaluate the physician’s knowledge of basic provisions of clinical guidelines for diagnosis and treatment of chronic heart failure (CHF) and to determine how the actions of physicians in their everyday clinical practice comply with these provisions.Materials and methods The study analyzed anonymous questionnaires of 185 physicians (127 cardiologists, 40 internists and general practitioners, 18 other specialists) who were trained in advanced training programs during the 2020/2021 academic year. The main part of the questionnaire included 15 questions related to the classification, diagnosis, pharmacotherapy, and the use of implantable devices in the treatment of patients with CHF.Results The results showed that internists were less than cardiologists aware of major provisions of clinical guidelines for diagnosis and treatment of CHF. However, the knowledge of cardiologists could not be considered sufficient either. 57.5% of internists and 30% of cardiologists incorrectly indicated the main echocardiographic criterion for diagnosis of CHF with reduced left ventricular ejection fraction (CHFrEF). More than 40% of internists did not consider fluid retention with development of the congestion syndrome as a mandatory condition for administration of a loop diuretic to a patient with CHFrEF. 34.6% of cardiologists and 25% of internists correctly determined the indication for the administration of mineralocorticoid receptor antagonists. 37.6% of internists and 21.1% of cardiologists incorrectly indicated the dose of spironolactone recommended for achieving the neuromodulation effect. In determining doses of angiotensin-converting enzyme (ACE) inhibitors and beta-blockers, after arriving at which it is necessary to stop their up-titration, most of the physicians preferred to be based on systolic blood pressure (SBP) rather than on symptoms of hypotension. However, among therapists there were doctors for whom the patient's well-being and clinical symptoms, and not the level of SBP, were priority factors for choosing the tactics of the treatment with ACE inhibitors and beta-blockers. Physicians of both specialties were poorly familiar with indications for cardioverter defibrillator implantation; only 14.2% of cardiologists and 5% of internists chose the correct wording of indications.Conclusion The insufficient knowledge should be considered the basis for the low adherence of doctors to guidelines for diagnosis and treatment of CHF. When developing programs for advanced training of physicians in CHF, special attention should be paid to the use of renin-angiotensin-aldosterone system inhibitors and beta-blockers with detailed discussion of the dosing principles as well as of indications for implantation and results of using cardioverter defibrillators.

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Doctor's attitude to administration of statins for primary prevention of cardiovascular diseases

Cited by 2 publications

References 0 publications

Methodological aspects of programs’ updating for advanced training of doctors

Methodological aspects of programs’ updating for advanced training of doctors

Physicians’ adherence to the guidelines on the chronic heart failure diagnosis and treatment

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