INTRODUCTION: Randomised controlled trials (RCTs) have informed guideline recommendations for the management of stable coronary artery disease (CAD). However, the real-world impact of contemporary guidelines and trials on practising physicians in the Asia-Pacific region remains uncertain. We aimed to evaluate the knowledge, attitudes and practices among cardiovascular physicians in the region regarding stable CAD management. METHOD: An anonymised cross-sectional electronic survey was administered to cardiovascular practitioners from the Asia Pacific, assessing 3 domains: 1) baseline knowledge on recent trials and society guideline, 2) attitudes towards stable CAD, and 3) case scenarios reflecting management preferences. Correlations among knowledge, attitudes and practice scores were assessed between physicians from developed and developing countries using Pearson correlation. RESULTS: Overall, 713 respondents from 21 countries completed the survey. The mean knowledge score was 2.90±1.18 (out of 4), with 37.3% of respondents answering all questions correctly, while 74.6% noted that guidelines have significant impact on their practice. Despite guidelines recommending optimal medical therapy, majority chose revascularisation (range 53.4- 90.6%) as the preferred strategy for the case scenarios. Practitioners from developed regions had higher knowledge scores and lower attitude scores compared to developing regions, while practice scores were similar in both groups. Weakly positive correlations were noted between knowledge, attitude and practice scores. CONCLUSION Variations exist in knowledge and attitudes towards guideline recommendations and correspondingly actual clinical practice in the Asia Pacific, with most practitioners choosing an upfront invasive strategy for the treatment of stable CAD. These differences reflect real-world disparities in guideline interpretation and clinical adoption.
Humans ; Coronary Artery Disease/therapy* ; Cross-Sectional Studies ; Practice Patterns, Physicians'/statistics & numerical data* ; Asia ; Health Knowledge, Attitudes, Practice ; Surveys and Questionnaires ; Male ; Practice Guidelines as Topic ; Female ; Attitude of Health Personnel ; Middle Aged ; Developing Countries

Introduction: The incidence of depression in coronary artery disease (CAD) is higher than in the general population. The factor is associated with depression is learned helplessness. Helplessness is one of the domains of illness cognition, which is someone’s preoccupation with unpleasant side effects of chronic disease related to daily functioning. Aim of this study was to determine the correlation between helplessness of illness cognition and symptoms of depression in CAD at Hasan Sadikin Hospital (RSHS), Bandung from November to December 2020. Method: The research method is a quantitative study with a cross-sectional design on CAD patients, male, and aged 55 years and over. Illness Cognition Questionnaire (ICQ) was used to assess illness cognition and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Results: This study involved 86 participants with a mean age of 62.4 ± 5.53 years, an average length of treatment of 3.4 ± 3.45 years, and 34 people (39.5%) had depressive symptoms. Of the 34 people who had depressive symptoms there were 4 persons (4.65%) with moderate depressive episodes and 1 person (1.16%) with major depressive episodes. The bivariate analysis using the rank Spearman correlation coefficient found that helplessness (r=0.337, p=0.001) had a significant relationship with depressive symptoms; whereas acceptance and perceived of benefit had no significant relationship with depression (r=-0.125, p=0.126,) and (r=0.035, p=0.374) respectively. Conclusion: This study concludes that depressive symptoms have a significant correlation with helplessness of illness cognition in CAD patient and there is a role of physician and cardiologist to help patients with these problems.