Influence of Clinician-Related Factors on Adherence to the American Heart Association Guidelines for Acute Coronary Syndrome among Clinicians at Kenya Ports Authority Clinics in Mombasa, Kenya
DOI:
https://doi.org/10.47604/jhmn.2549Keywords:
Clinician-Related Factors, Adherence, American Heart Association Guidelines, Acute Coronary Syndrome, CliniciansAbstract
Purpose: The aim of the study was to assess influence of clinician-related factors on adherence to the American heart association guidelines for acute coronary syndrome among clinicians at Kenya Ports Authority clinics in Mombasa, Kenya.
Methodology: A descriptive cross-sectional study involving quantitative methods of data collection was adopted. An interviewer administered questionnaire was used for data collection. The study was carried out in Kenya Ports Authority clinics in Mombasa, Kenya. The target population was 106 clinicians attending to patients who present with Acute Coronary Syndrome at the KPA clinics in Mombasa. A census method was used to determine the study participants. The sample size was made up of a hundred and six participants. The clinicians who consented to participate in the study were included while those who were on sick off, leave or who recently joined the clinic were excluded. Pretesting of the study tool was done at the Kenya Pipeline Clinic Mombasa. Data analysis was done using Statistical Package for Social Sciences version 25 and presented via tables.
Findings: The study results showed that at 95% level of confidence (Ï-value = 0.05%), there was a significant association between gender (á¾³=0.025), work experience (á¾³=0.016), job cadre (á¾³=0.014) and training received (á¾³=0.022) on adherence to the American Heart Association Guidelines for Acute Coronary Syndrome among clinicians at Kenya Ports Authority clinics in Mombasa, Kenya. The association was insignificant between age (á¾³=0.178), education level (á¾³=0.439) and specialization (á¾³=0.489) on adherence to the AHA guidelines.
Unique Contribution to Theory, Practice and Policy: The study recommends that the KPA management should increase the medical budget to ensure availability of adequate resources for ACS patient management. These resources include adequate staffing, medication, equipment, and staff training costs. The clinic management should ensure that medications such as aspirin, morphine and nitroglycerine are readily available and accessible at patients care points. The KPA clinic management to formulate a simple algorithm that outlines the steps to be taken when managing ACS patients. The study recommends that the clinics should assess their equipment reqularly for maintenance controls to ensure efficiency. The study further recommends random assessments and post care audits to assess the adherence to ACS guidelines among clinicians. Training associated with adherence to the AHA guidelines and as such, KPA should continue offering training and education on the latest AHA guidelines for ACS to ensure updated guidelines for practice.
Downloads
References
Anderson, B. R. (2017). Improving health care by embracing Systems Theory. Journal of Thoracic and Cardiovascular Surgery, 152(2), 593-594. https://doi.org/10.1016/J.JTCVS.2016.03.029
Barth, J. H., Langlois, M. R., Twomey, P. J., Misra, S., Aakre, K. M., Watine, J., & Oosterhuis, W. P. (2016). Mini Review Why are clinical practice guidelines not followed? Clin Chem Lab Med, 54(7), 1133-1139. https://doi.org/10.1515/cclm-2015-0871
Doroodchi, H., Abdolrasulnia, M., Foster, J. A., Foster, E., Turakhia, M. P., Skelding, K. A., ... & Casebeer, L. L. (2008). Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events. BMC family practice, 9(1), 1-9.
Fischer, F., Lange, K., Klose, K., Greiner, W., & Kraemer, A. (2016). Barriers and Strategies in Guideline Implementation"”A Scoping Review. Healthcare 2016, Vol. 4, Page 36, 4(3), 36. https://doi.org/10.3390/HEALTHCARE4030036
Francke, A. L., Smit, M. C., De Veer, A. J. E., & Mistiaen, P. (2008). Factors influencing the implementation of clinical guidelines for health care professionals: A systematic meta-review. BMC Medical Informatics and Decision Making, 8. https://doi.org/10.1186/1472-6947-8-38
Galaviz, K. I., Colasanti, J. A., Kalokhe, A. S., Ali, M. K., Ofotokun, I., & Fernandez, A. (2022). Factors associated with adherence to guideline-recommended cardiovascular disease prevention among HIV clinicians. Translational behavioral medicine, 12(1), ibab125.
Indira. (1989). General systems theory. Narayana Nursing Journal, 28(3), 36-40. https://doi.org/10.4324/9781849771917-7
Jiang, V., Marshall Brooks, E., Tong, S. T., Heintzman, J., & Krist, A. H. (2020). Factors Influencing Uptake of Changes to Clinical Preventive Guidelines. Journal of the American Board of Family Medicine : JABFM, 33(2), 271. https://doi.org/10.3122/JABFM.2020.02.190146
Jones, J. A., & Reeve, C. A. (2018). Factors influencing the use of clinical guidelines by general practitioners working in a setting of complex multimorbidity: a case study by interviews. BMC Family Practice, 19(1), 157. https://doi.org/10.1186/S12875-018-0834-2
Kakou-Guikahue, M., N'Guetta, R., Anzouan-Kacou, J. B., Kramoh, E., N'Dori, R., Ba, S. A., ... & Monsuez, J. J. (2016). Optimizing the management of acute coronary syndromes in sub-Saharan Africa: A statement from the AFRICARDIO 2015 Consensus Team. Archives of cardiovascular diseases, 109(6-7), 376-383.
Luz, O., Lina, A., Maria, A., & Wilmar, M. (2020): Factors Affecting Treatment Adherence of Patients in a Cardiac Care Unit". EC Nursing and Healthcare (2), 8; 77-86.
McGinty, J., & Anderson, G. (2008). Predictors of physician adherence with American Heart Association guidelines for acute myocardial infarction. Critical Care Nursing Quarterly, 31(2), 161-172.
Mozaffarian, D. (2016). Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: a comprehensive review. Circulation, 133(2), 187-225.
Pallangyo, P., Millinga, J., Bhalia, S., Mkojera, Z., Misidai, N., Swai, H. J., ... & Janabi, M. (2020). Medication adherence and survival among hospitalized heart failure patients in a tertiary hospital in Tanzania: a prospective cohort study. BMC research notes, 13(1), 1-8.
Rajesh, D. (2019). Adherence/Adherence to the Standard Guidelines for Management of Acute Coronary Syndrome-Tertiary Care Centre Study. International Journal of Contemporary Medical Research, (6),12, 13-18.
Ralapanawa, U., & Sivakanesan, R. (2021). Epidemiology and the magnitude of coronary artery disease and acute coronary syndrome: A narrative review. Journal of Epidemiology and Global Health, 11(2), 169.
Raz, D. J., Wu, G. X., Consunji, M., Nelson, R. A., Kim, H., Sun, C. L., ... & Kim, J. Y. (2018). The effect of primary care physician knowledge of lung cancer screening guidelines on perceptions and utilization of low-dose computed tomography. Clinical lung cancer, 19(1), 51-57.
Sasaki, N., Yamaguchi, N., Okumura, A., Yoshida, M., Sugawara, H., Shin, J. ho, Kunisawa, S., & Imanaka, Y. (2020). Factors affecting the use of clinical practice guidelines by hospital physicians: the interplay of IT infrastructure and physician attitudes. Implementation Science, 15(1), 1-10. https://doi.org/10.1186/S13012-020-01056-1/TABLES/4
Sorato, M. M., Davari, M., Kebriaeezadeh, A., Sarrafzadegan, N., Shibru, T., & Fatemi, B. (2021). Reasons for poor blood pressure control in eastern sub-Saharan Africa: looking into 4P's (primary care, professional, patient, and public health policy) for improving blood pressure control: a scoping review. BMC cardiovascular disorders, 21(1), 1-15.
Weston, S. J., Graham, E. K., Turiano, N. A., Aschwanden, D., Booth, T., Harrison, F., ... & Mroczek, D. K. (2017). Is healthy neuroticism associated with chronic conditions? A coordinated integrative data analysis. Collabra: Psychology, 6(1).
WHO. (2016). Technical package for cardiovascular disease management in primary health care. Report.
World Health Organization (2020). The Global Health Observatory (GHO) WHO. [Online] 2020. https://www.who.int/data/gho/.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Mary Kavinya Mailu, Dr. Nilufa Jivraj Shariff, PhD, Dr. Ruth Mbugua, PhD
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.