title: Secondary prevention of heart disease--knowledge among cardiologists and omega-3 (omega-3) fatty acid prescribing behaviors in Karachi, Pakistan.
abstract: BACKGROUND
  The use of omega-3 fatty acids is a currently proven strategy for secondary prevention of heart disease. The prescription practices for this important nutraceutical is not currently known. It is imperative to assess the knowledge of cardiologists regarding the benefits of omega-3 fatty acids and to determine the frequency of its prescription. The aim of the study was to determine the practices and associations of dietary fish prescribing among cardiologists of Karachi and to assess their knowledge of fish oil supplementation and attitudes toward dietary practices.
  
  
  METHODS
  A cross sectional survey was conducted during the period of January to March, 2008. A self report questionnaire was employed. All practicing cardiologists of Karachi were included in the study. Multiple logistic regression analysis was performed to determine the independent factors associated with high fish prescribers.
  
  
  RESULTS
  The sample comprised of a total of 163 cardiologists practicing in Karachi, Pakistan. Most (73.6%) of the cardiologists fell in the age range of 28-45 years and were male (90.8%). High fish prescribers only comprised 36.2% of the respondents. After adjusting for age and gender, multivariate analysis revealed that only the variable of knowledge about fish oil's role in reducing sudden cardiac death was independently associated with high fish prescribers OR = 6.38 [95% CI 2.58-15.78].
  
  
  CONCLUSIONS
  The level of knowledge about the benefits of omega-3 fatty acids is high and the cardiologists harbor a favorable attitude towards dispensing dietary fish advice. However, the prescription practices are less than optimal and not concordant with recommendations of organisations such as the American Heart Association and National Heart Foundation of Australia. The knowledge of prevention of sudden cardiac death in CVD patients has been identified as an important predictor of high fish prescription. This particular life-saving property of omega-3 fatty acids should be the focus of any implemented educational strategy targeted to improve secondary CVD prevention via omega-3 fatty acid supplementation.
authors.affiliation: Section of Cardiology, Department of Medicine, Aga Khan University, Aga Khan, Pakistan. saqibgowani@gmail.com
authors.forename: Saqib A
authors.initials: SA
authors.lastname: Gowani
authors.forename: Sana
authors.initials: S
authors.lastname: Shoukat
authors.forename: Ather M
authors.initials: AM
authors.lastname: Taqui
authors.forename: Hashim M
authors.initials: HM
authors.lastname: Hanif
authors.forename: Wasiq F
authors.initials: WF
authors.lastname: Rawasia
authors.forename: Zeeshan
authors.initials: Z
authors.lastname: Qadri
authors.forename: Sajid H
authors.initials: SH
authors.lastname: Dhakam
mesh_terms: D000328:Adult; D000572:American Heart Association; D002309:Cardiology / Q000193:education; D003430:Cross-Sectional Studies; D019587:Dietary Supplements / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D005395:Fish Oils / Q000627:therapeutic use*; D006331:Heart Diseases / Q000378:metabolism / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce
chemical_list: D015525:Fatty Acids, Omega-3; D005395:Fish Oils