Journal Article

Adherence to guidelines for natriuretic peptide testing in heart failure: a nationwide survey of healthcare professionals in Vietnam

Do, Doan-Loi, Le, Dung Van, Tran, Ngoc-Anh Thi, Pham, Nguyen-Son, Vu, Quynh-Nga, Dang, Duy-Phuong, Thi Tran, Hai-Ha, Huu Bui, Minh-Tri, Vu Tran, Minh-Thu, Kim, Ngoc-Thanh, Thi Nguyen, Kieu-Ly, Vu, Quoc-Oai, Phan, Thao-Nguyen, Thi Nguyen, Minh-Ly, Bui, The-Dung, Truong, Thanh Huong, Pham, Minh-Tuan, Hoang, Anh-Tien, Nguyen, Diem Thi, Cu, Nhat-Quy, Nguyen, Huy-Loi, Do, Xuan-Thu, Khong, Tien-Binh, Hoang, Van-Sy, Le, Thanh-An, Thi Nguyen, Thanh-Trung, Phan, Dinh-Phong, Ha, Quang-Tao, Le, Gia-Hoang, Nguyen, Phuong-Anh, Ho, Phuoc Van, Le, The-Anh, Nguyen, Thoa Thi

2025

Overview

ObjectivesThis study aimed to determine doctors’ level of adherence to the natriuretic peptide testing guideline and to identify the factors influencing their adherence.DesignCross-sectional study.SettingWeb-based survey.ParticipantsFull-time doctors involved in heart failure (HF) treatment in Vietnam.Primary and secondary outcome measuresDoctors using natriuretic peptide testing for diagnosis, differential diagnosis, treatment assessment and prognosis of patients with HF were classified as adhering to the guidelines. We assessed the practice of natriuretic peptide testing and stratified the doctors based on their professional qualifications. Univariate and multivariate logistic regression analyses were used to estimate the Odds Ratio (ORs) and 95% CIs for associations between guideline adherence and selected covariates.ResultsOver half of the participants adhered to the natriuretic peptide testing guidelines (57.4%). Cardiologists adhered more closely to the guidelines than other professionals; they had approximately four times higher odds of adherence than other doctors (univariate model, OR: 3.88, 95% CI: 2.56 to 5.89, p<0.001; multivariate model, OR: 4.24, 95% CI: 2.64 to 6.82, p<0.001). Cardiologists also had significantly higher rates of using natriuretic peptide testing for diagnosis (93.8% vs 84.1%, p<0.002), differential diagnosis (71.4% vs 53.5%, p<0.001), treatment assessment (87% vs 64.2%, p<0.001) and prognosis (68.2% vs 50.4%, p<0.001) than other professionals. More years of professional experience correlated with higher guideline adherence (<2 years was used as a reference point; >5 to <10 years, OR: 2.59, 95% CI: 1.45 to 4.60, p<0.001; ≥10 years, OR: 2.30, 95% CI: 1.30 to 4.09, p<0.004).ConclusionThe level of adherence to natriuretic peptide testing guidelines among doctors treating patients with HF varies across Vietnam. Targeted interventions are needed to enhance understanding and proficiency, especially among non-cardiologists and those with limited experience. A dedicated fact sheet focusing on natriuretic peptide testing in HF management, separate from the existing guidelines, could bridge this gap.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Adult / Biomarkers / Cardiologists - standards / Cardiologists - statistics & numerical data / Cardiology / Cardiovascular Medicine / Cross-Sectional Studies / Ethics / Female / Guideline Adherence - statistics & numerical data / Health facilities / Heart failure / Heart Failure - blood / Heart Failure - diagnosis / Humans / Logistic Models / Male / Medical diagnosis / Medical personnel / Medical prognosis / Medication Adherence / Middle Aged / Natriuretic Peptide, Brain - blood / Natriuretic Peptides - blood / Original Research / Peptides / Physicians / Practice Guidelines as Topic / Practice Patterns, Physicians' - statistics & numerical data / Professionals / Protocols & guidelines / Questionnaires / Surveys and Questionnaires / Ultrasonic imaging / Vietnam