Literature DB >> 19929180

General practitioners' adherence to guidelines on management of dyslipidaemia: ADDITION-Denmark.

Lise Graversen1, Bo Christensen, Knut Borch-Johnsen, Torsten Lauritzen, Annelli Sandbaek.   

Abstract

OBJECTIVE: To describe the management of dyslipidaemia in patients with high risk of cardiovascular disease (CVD) and patients with a history of CVD identified by screening for diabetes in general practice in Denmark, concentrating on prescription of lipid-lowering drugs. Moreover, to analyse predicting factors for starting lipid-lowering drugs related to patient and general practice characteristics.
DESIGN: Population-based cross-sectional study with follow-up.
SETTING: A total of 139 general practices from three of five Danish regions, totalling 216 GPs.
SUBJECTS: The study population comprised 4986 patients with a high risk of CVD and dyslipidaemia and 764 patients with a history of CVD and dyslipidaemia out of a population of 16 572 patients who completed screening for diabetes but were cleared for diabetes in the ADDITION study.
RESULTS: Of patients with a high risk of CVD and dyslipidaemia not receiving lipid-lowering drugs at the time of screening (n = 4823), 20% started lipid-lowering therapy within the follow-up period (median 2.1 years). This percentage was 45% (n = 536) for patients with CVD and dyslipidaemia (median follow-up period 1.6 years). Age over 50, high cholesterol, impaired fasting glucose and/or impaired glucose tolerance, minor polypharmacy, use of heart/circulation drugs, and cholesterol measurements after screening predicted the prescription of lipid-lowering drugs for patients at high risk of CVD. For patients with CVD, male gender, high cholesterol and use of heart/circulation drugs predicted the prescription of lipid-lowering drugs. No general practice characteristics were associated with different prescription habits.
CONCLUSION: There is a gap between the recommended lipid-lowering drug therapy and current practice, with a substantial under-treatment and a considerable delay in the first prescription of lipid-lowering drugs.

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Year:  2010        PMID: 19929180      PMCID: PMC3440615          DOI: 10.3109/02813430903335216

Source DB:  PubMed          Journal:  Scand J Prim Health Care        ISSN: 0281-3432            Impact factor:   2.581


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