Doctors’ Adherence to the Guidelines in Managing Patients in the Coronary Care Unit

Background: Cardiovascular diseases (CVDs) are the leading cause of death worldwide. While lifestyle changes contribute to their prevalence, regional differences exist. Arrhythmias and acute coronary syndromes (ACS) pose significant burdens on healthcare systems, necessitating specialized care and interventions. Thus, the adherence to the international guidelines plays an important role in patients' management and improving the outcomes. Aim of the study is assessing doctors' adherence to guidelines for patients management in the cardiac care unit in Mosul City.
Methods: A case series study was conducted in three main hospitals (Ibn Sina, Al-Salam, and AL-Mosul General Hospitals) that contain CCU in Mosul City. The participants were chosen by using a nonprobability judgmental sampling strategy. This approach ensured the inclusion of all participants who met the study criteria resulting in a total of 53 doctors working in the CCU of the mentioned hospitals. Face-to-face interviews were conducted during working hours with no exclusion criteria. Between December 2023 and February 2024, data were gathered using a questionnaire form that was developed based on international guidelines and approved by a pilot study. The study utilized statistical analysis with SPSS, using descriptive statistics and the Fisher exact /Chi-square test to measure the associations between variables at a significance level of p 0.05.
Results: In the CCU, respecting patients' autonomy by physicians revealed a significant difference between different degrees of specialty being better among sub-seniors (94.7%) and lowest (50%) for senior doctors. Resident doctors revealed high response in initiating high-quality CPR (70.8%) and educating about self-care and arrhythmia medications (83.3%), while senior doctors fall behind in providing privacy and considering early invasive strategies for ACS (only 50% for each).
Conclusion: This study revealed a good commitment of physicians toward many aspects of patients' management in the CCU and defects in others. These findings underscore the necessity for standardized guidelines and on-going professional development to ensure high-quality and consistent care for cardiac patients.