ABSTRACT NUMBER: ESOC2026A2007 KNOWLEDGE, ATTITUDES, AND USE OF NEUROPROTECTIVE AGENTS IN ACUTE ISCHEMIC STROKE: A NATIONWIDE SURVEY OF 1,983 NEUROLOGISTS IN CHINA

Abstract Background and aims Neuroprotective agents are widely used in China, yet the extent to which prescribing is driven by evidence-based knowledge versus clinicians’ beliefs remains unclear. We assessed knowledge–attitude–practice patterns and their determinants among Chinese neurologists. Methods We conducted a nationwide cross-sectional survey of neurologists from 31 provinces (248 hospitals). We assessed knowledge (Q10), attitudes (Q12 total), perceived benefit (Q15–18 mean), and frequency of neuroprotective use (Q14); high-frequency use was defined as Q14≥4. We evaluated knowledge–practice correlation and mismatch, multivariable logistic regression, and structural equation modeling (SEM). Results A total of 1,983 neurologists responded (88% from tertiary hospitals); 1,982 were analyzed. High-frequency use was reported by 80.5% (1,596/1,982). Knowledge and use were modestly correlated (Spearman ρ=0.144; p<0.001), and 37.5% (743/1,982) reported low knowledge but high use. In logistic regression, perceived benefit showed the strongest association with high-frequency use (OR 2.52 per 1-point; 95% CI 2.04–3.12; p<0.001), exceeding knowledge (OR 1.20; p=0.011) and attitudes (OR 1.05; p=0.009); model discrimination was AUC=0.718. SEM suggested knowledge influenced use mainly indirectly via perceived importance, attitudes, and perceived benefit, with perceived benefit as the dominant proximal driver. Conclusions Neuroprotective use is highly prevalent in China with substantial knowledge–practice mismatch. Interventions should target benefit beliefs and evidence literacy and strengthen the trial evidence base to clarify when use is warranted. Conflict of interest Zefeng Tan, nothing to diclose