DOCTOR’S ADHERENCE TO RECOMMENDATIONS GOVERNING THE ANTIPLATELET AGENTS USE IN THE CARDIOVASCULAR DISEASES PREVENTION AND TREATMENT

Abstract

Aim. To study the doctors' opinions on the main aspects of antiplatelet agents use, and to test their knowledge of the basic provisions of the current recommendations on antiplatelet therapy. Material and methods. As a material for the study the results of an anonymous questionnaire in randomly selected doctors were used. The questionnaire contained 11 questions concerning the use of antiplatelet agents for primary and secondary prevention of cardiovascular diseases. 276 questionnaires filled out by 185 therapists, 84 cardiologists and 7 physicians of other therapeutic specialties were analyzed. Results. The results of the study reflect the doctor’s tendency to use acetylsalicylic acid for the primary prevention of cardiovascular diseases, including the patients who do not have indications for its prescribing. 11.6% of respondents never recommend acetylsalicylic acid for primary prevention of cardiovascular diseases. 22.8% of doctors don’t consider it necessary to stop acetylsalicylic acid in patients who do not have indications for such treatment. Therapists demonstrate very low adherence to recommendations which underline the need for a weighted approach to the acetylsalicylic acid prescription. Cardiologists less often than therapists recommend acetylsalicylic acid for the primary prevention of cardiovascular disease in patients with low cardiovascular risk. Less than 30% of therapists and cardiologists tend to prescribe gastroprotectors to patients with aspirin-induced gastropathy. Only 19.6% of the respondents correctly indicated the P2Y12 receptor inhibitor dose to be used in combination with acetylsalicylic acid on the 1st day of acute coronary syndrome depending on planed treatment strategy. 88.4% of doctors consider the use of antiplatelet agents, if the patient with atrial fibrillation and a high risk of thromboembolism refused to take oral anticoagulants. 51.8% of respondents recommend a combination of acetylsalicylic acid and clopidogrel for such patients. Cardiologists are better informed about the recommendations regarding the use of dual antiplatelet therapy and a combination of antiplatelet agents with oral anticoagulants. However, in general, doctors' knowledge of combined antithrombotic therapy is inadequate. Conclusion. The results of the study show that it is necessary to discuss current recommendations on the use of antiplatelet agents for the primary and secondary prevention of cardiovascular diseases in the context of continuous medical education more actively.