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

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.