Knowledge, Attitude, and Practice of Heart Failure Management by Physicians Practicing in Cardiology Services in Kinshasa, Democratic Republic of the Congo

Objective: This paper aims to assess the knowledge of the European Society of Cardiology (ESC) guidelines for the diagnosis and treatment of heart failure (HF), and to describe the attitude towards and the practice of HF management by physicians who practice in cardiology services in Kinshasa, Democratic Republic of the Congo (DRC). Methods: In April 2022, a trained interviewer visited all Kinshasa hospitals and healthcare facilities where adult cardiology services are provided to solicit voluntary participation of providers of those services in this study. Knowledge of the ESC guidelines for the diagnosis and treatment of HF among respondents and their attitude towards and practice of HF management were recorded on a nominal scale. Data were summarized as percentages and reported separately between 14 cardiologists and 24 general practitioners. Chi-square tests were used for all comparisons. Significance level was set at p < 0.05. Results: All cardiologists (100.0%) and 83.3% of general practitioners (p = 0.276) refer to guidelines of the ESC in their standard practice. The overall knowledge of the ESC guidelines for the diagnosis and treatment of HF among cardiologists was very good, but more needs to be done to improve that knowledge among general practitioners. For example, there was a significant difference between cardiologists and general practitioners in the knowledge of HF management of patients with iron deficiency (71.4% vs. 37.5%, respectively; p < 0.044) and a borderline significant difference in the knowledge of management of patients with type 2 diabetes who develop HF (92.9% vs. 62.5%, respectively; p < 0.059) in a city with a high prevalence of both iron deficiency and poorly controlled type 2 diabetes. Most providers do not know the in-hospital prevalence of HF in Kinshasa (cardiologists: 46.2%; general practitioners: 55.6%), but almost all perceive that this unknown prevalence tends to increase (cardiologists: 100.0%; general practitioners: 91.3%). Nearly three quarters think that hypertension is the leading morbidity of HF in Kinshasa (cardiologists: 71.4%; general practitioners: 70.8%). Satisfaction with HF management is low: 61.5% of cardiologists and 62.5% of general practitioners are less, or not much, satisfied with how HF is managed. They attribute the non-optimal HF management in the DRC to financial, structural, and organizational factors. Conclusions: Survey respondents paved the way toward setting up a research agenda for starting the as yet non-existing work of systematically studying