4.6 Article

Preventive Medicine in Pediatric Cardiology Practice

Journal

JOURNAL OF PEDIATRICS
Volume 253, Issue -, Pages 14-+

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2022.08.034

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The study aimed to assess pediatric cardiologists' practice patterns regarding cholesterol disorders and smoking-related illness. The results showed that many doctors had little formal training in cholesterol disorders and underestimated the prevalence of familial hypercholesterolemia. Regarding smoking-related illness, doctors also lacked formal training and had low rates of screening for tobacco use.
Objectives The objective of the study was to assess contemporary practice patterns of pediatric cardiologists with respect to cholesterol disorders and smoking-related illness.Study design We sent 2 anonymous surveys to the members of the American Academy of Pediatrics Section on Cardiology and Cardiac Surgery and the Pediheart online community. The surveys addressed training in and man-agement of cholesterol disorders and smoking-related illness. Results There were 97 responses to the cholesterol disorders survey. A total of 51.6% reported little or no formal training on cholesterol disorders. A total of 56.4% underestimated the prevalence of familial hypercholesterolemia by at least twofold. A total of 54.7% were at least somewhat comfortable prescribing statins. In 5 clinical vignettes, respondents frequently gave clinical recommendations in line with the 2019 American Heart Association guidelines although both undertreatment and overtreatment were recommended. There were 90 responses to the survey on smoking-related illness. Little or no formal training in nicotine addiction (52.3%) or smoking cessation (60.5%) was reported by respondents. Respondents screened for tobacco use in less than a one-third of hospitalizations and less than two-thirds of outpatient clinic visits. Screening for exposure to secondhand smoke was even less com-mon. Twenty-seven percent of respondents never recommend a household smoking ban for their patients. A total of 83.3% were uncomfortable prescribing medications for their patients for smoking cessation, and 65.5% rarely or never refer patients for smoking cessation assistance.Conclusion Although positioned to address the childhood origins of adult heart disease, those cardiologists sur-veyed placed a limited emphasis on cholesterol disorders and smoking-related disease in their clinical practice. (J Pediatr 2023;253:14-7).

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