Knowledge, Attitudes, and Practices Regarding PCSK9 Inhibitors Among Healthcare Professionals: Exploring Behavioral Pathways and the Intermediary Role of Attitude

Introduction: The aim of the current study was to assess the knowledge, attitudes, and practices (KAP) of healthcare professionals about proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and to explicitly explore the behavioral pathways linking these domains, focusing on how attitude connects knowledge to clinical practice. Methods: A cross-sectional study was carried out with a structured, self-complete questionnaire sent to healthcare workers of the Xuzhou area from October 2024 to July 2025. Demographic data of the respondents as well as KAP scores were obtained and compared. Knowledge, attitude, and practice interactions were analyzed with Spearman correlation and structural equation modeling. Results: 512 usable responses for analysis. The mean scores were 10.05 ± 2.61 for knowledge, 23.78 ± 5.04 for attitude, and 31.71 ± 6.40 for practice. Knowledge, attitude, and practice were positively correlated with each other (P < 0.001). SEM analysis indicated that attitude was a mediator of the relationship between knowledge and practice in a full sense. Knowledge exerted a significant direct influence on attitude (β = 0.873, P < 0.001) and an indirect effect on practice (β = 0.702, P = 0.005), but the direct path from knowledge to practice was not significant statistically (P = 0.124). Conclusion: Clinical practitioners demonstrated moderate levels of knowledge and self-reported practice regarding PCSK9 inhibitors that were underpinned by a generally positive attitude. Attitude was associated with practice and statistically mediated the knowledge–practice association within the proposed model. Educational activities should therefore aim not only to remedy gaps in knowledge but also to foster professional attitudes for the facilitation of the clinical use of PCSK9 inhibitors.