Secondary prevention and cardiovascular care across Europe: A survey of European Society of Cardiology members’ views

Abstract

Introduction: Secondary prevention of cardiovascular disease is a significant clinical challenge and despite European Society of Cardiology (ESC) Guidelines, evidence confirms sub-optimal patient care. Aim: The aim of this study was to evaluate ESC members’ opinions on the current provision of cardiovascular prevention and rehabilitation services across Europe and explore barriers to guideline implementation. Method: Electronic surveys using a secure web link were sent to members of the ESC in eight purposively selected ESC affiliated countries. Results: A total of 479 professionals completed the survey, of whom 67% were cardiologists, 8.6% general physicians, 8.2% nurses and 16.2% other healthcare professionals. Respondents were predominantly (91%) practising clinicians, generally highly motivated regarding cardiovascular disease prevention, but most reported that secondary prevention in their country was sub-optimal. The main barriers to prevention were lack of available cardiac rehabilitation programmes and long-term follow-up, patients’ disease perception and professional attitudes towards prevention. While knowledge of the prevention guidelines was generally good, practices such as motivational counselling and better educational tools were called for to promote exercise, smoking cessation and for nutritional aspects. Conclusions: The provision of services focusing on the secondary prevention of cardiovascular disease varies greatly across Europe. Furthermore, despite ESC Guidelines and a strong evidence base supporting the efficacy of secondary prevention, the infrastructure and co-ordination of such care is lacking. In addition patient motivation is considered poor and some professionals remain unconvinced about the merits of prevention. The disappointing results outlined in this survey emphasise that improved tools are urgently required to educate both patients and professionals and confirm the priority of cardiovascular prevention internationally.

Perspectives on the Human Adaptation Potential

“…The factors that are difficult to change are chronic kidney disease, obstructive apnea syndrome, low socioeconomic, and educational status. Age and involutional changes, male gender, and heredity remain unmodulated risk factors for cardiovascular complications [16,17]. The aggravating role of emotional stress in the development of pathology of the cardiovascular system according to the results of expert mathematical analysis for this group of men was absent.…”

Research methods: Time to get excited!

“…The European Journal of Cardiovascular Nursing is dedicated to the advancement of knowledge in the field of cardiovascular care and the promotion of evidence-based clinical practice. This means that we publish articles with a diverse range of research methods, such as surveys, 1 qualitative studies, 2 pilot studies, 3 randomised controlled trials 4 or systematic reviews and meta-analyses. 5 These are just a few examples of the approaches needed to address the variety of research questions posed in cardiovascular clinical practice.…”

Optimising secondary prevention and cardiovascular care across Europe: A UK perspective on a common goal

“…We read with great interest a recent article entitled ‘Secondary prevention and cardiovascular care across Europe: a survey of European Society of Cardiology members’ views’. 1 In this survey of 479 healthcare professionals from eight countries, the main barriers identified were lack of available cardiac rehabilitation programmes and long-term follow-up, patients’ disease perception and professional attitudes towards prevention. Barriers to prevention varied based on the survey participants’ country of origin; however, there was consensus across all countries on the three most important strategies to improve prevention, namely multidisciplinary interventions, patient education and introducing performance measures.…”

“…Barriers to prevention varied based on the survey participants’ country of origin; however, there was consensus across all countries on the three most important strategies to improve prevention, namely multidisciplinary interventions, patient education and introducing performance measures. 1 In the UK, shortcomings in the delivery of secondary prevention programmes have also been linked with suboptimal outcomes for patients with cardiovascular disease (CVD), and recently a group of multidisciplinary team (MDT) members working in secondary prevention in primary and secondary care settings has developed a UK consensus on optimising CVD secondary prevention care. 2…”

“…The data analysis from Fitzsimons et al. 1 underlines that secondary prevention is often suboptimal across the European countries included in the European Society of Cardiology (ESC) survey. Given that MDT members are central to delivering CVD secondary care, it is understandable that an Association of Cardiovascular Nursing and Allied Professions (ACNAP) task force is currently examining ways to support greater collaboration between allied professions and to address uncertainties about the roles that different MDT members can play in CVD secondary prevention.…”