Current Frailty Knowledge, Awareness, and Practices Among Physicians following the 2022 European Consensus Document on Frailty in Cardiology

European Heart Journal Open Pub Date : 2024-03-27 DOI:10.1093/ehjopen/oeae025

Jie Jun Wong, Laureen Yi-Ting Wang, K. Hasegawa, Kay Woon Ho, Zijuan Huang, L. Teo, Jack Wei Chieh Tan, Kazuyuki Kasahara, R. Tan, Junbo Ge, A. Koh

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Abstract

Aging-related cardiovascular disease and frailty burdens are anticipated to rise with global aging. In response to directions from major cardiovascular societies, we investigated frailty knowledge, awareness, and practices among cardiologists as key stakeholders in this emerging paradigm a year after the European Frailty in Cardiology consensus document was published. We launched a prospective multinational web-based survey via social networks to broad cardiology communities representing multiple World Health Organization regions, including Western Pacific and Southeast Asia regions. Overall, 578 respondents [38.2% female; ages 35-49 years (55.2%), 50-64 years (34.4%)] across subspecialties, including interventionists (43.3%), general cardiologists (30.6%), and heart failure specialists (HFs) (10.9%), were surveyed. Nearly half had read the consensus document (38.9%). Non-interventionists had better perceived knowledge of frailty assessment instruments (fully or vaguely aware, 57.2% vs 45%, adj. p=0.0002), exercise programs (well aware, 12.9% vs 6.0%, adj. p=0.001), and engaged more in multidisciplinary team care (frequently or occasionally 52.6% vs 41%, adj. p=0.002) than interventionists. HFs more often addressed preprocedural frailty (frequently or occasionally, 43.5% vs 28.2%, p=0.004) and polypharmacy (frequently or occasionally, 85.5% vs 71%, adj. p=0.014), and had consistently better composite knowledge (39.3% vs 21.6%, adj. p=0.001) and practice responses (21% vs 11.1%, adj. p=0.018) than non-HFs. Respondents with better knowledge responses also had better frailty practices (40.3% vs 3.6%, adj. p<0.001). Distinct response differences suggest that future strategies strengthening frailty principles should address practices peculiar to subspecialties, such as preprocedural frailty strategies for interventionists and rehabilitation interventions for heart failure specialists.

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遵循《2022 年欧洲心脏病学虚弱共识文件》的医生对虚弱的现有了解、认识和做法

随着全球老龄化的加剧，预计与老龄化相关的心血管疾病和虚弱负担将不断增加。为了响应主要心血管协会的指示，我们在《欧洲心脏病学中的虚弱》共识文件发表一年后，调查了作为这一新兴模式主要利益相关者的心脏病学家对虚弱的了解、认识和实践。我们通过社交网络向代表世界卫生组织多个地区（包括西太平洋和东南亚地区）的广大心脏病学社区发起了一项前瞻性跨国网络调查。总共有 578 名受访者[38.2% 为女性；年龄在 35-49 岁（55.2%）和 50-64 岁（34.4%）之间]接受了调查，他们来自各个亚专科，包括介入专家（43.3%）、普通心脏病专家（30.6%）和心力衰竭专家（10.9%）。近一半的人阅读过共识文件（38.9%）。与干预者相比，非干预者对虚弱评估工具（完全了解或模糊了解，57.2% 对 45%，修正后 p=0.0002）、运动计划（非常了解，12.9% 对 6.0%，修正后 p=0.001）和多学科团队护理（经常或偶尔了解，52.6% 对 41%，修正后 p=0.002）的认知度更高。与非高血压患者相比，高血压患者更经常处理术前虚弱问题（经常或偶尔，43.5% vs 28.2%，adj. p=0.004）和多药治疗问题（经常或偶尔，85.5% vs 71%，adj. p=0.014），其综合知识（39.3% vs 21.6%，adj. p=0.001）和实践反应（21% vs 11.1%，adj. p=0.018）也一直更好。知识回答较好的受访者也有较好的虚弱实践（40.3% vs 3.6%，adj. p<0.001）。不同的回答差异表明，未来加强虚弱原则的策略应针对亚专科的特殊实践，如介入专家的术前虚弱策略和心衰专家的康复干预。

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European Heart Journal Open

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