Management of atherogenic dyslipidemia according to current treatment guidelines: DESPEGA study in real clinical practice
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Studies in patients with dyslipidemia have revealed that, despite guideline recommendations, treatment remains unchanged even when therapeutic goals are not achieved.
Our objective was to determine the degree to which primary care (PC) and specialty care (SC) physicians adhere to clinical guidelines for the management of atherogenic dyslipidemia (AD).
This was an observational, descriptive, cross-sectional study. Physicians working in the Spanish Health System completed an electronic questionnaire comprising 24 items organized into three blocks: clinical guidelines, adherence to clinical guidelines, and other issues in the management of AD. The questions were formulated with closed polytomous or categorized responses. Adherence to guidelines, in terms of treatment, was assessed according to physicians’ responses to six patient profiles. Absolute and relative frequencies (qualitative variables), central tendency and dispersion (quantitative variables) were calculated.
In total, 980 physicians (88.5% PC) participated in the study; 77.3% used guidelines in their routine clinical practice, with the most used being the Spanish SEMERGEN (73.8%) and the European Society of Cardiology/European Atherosclerosis Society guidelines (41.2%). A total of 83% adhered to guideline recommendations in more than four of the six profiles proposed, 26.2% adhered to the SEMERGEN definition of AD, 66.6% combined all lipoprotein ratios to diagnose AD, and > 60% used non-high-density lipoprotein cholesterol (HDL-C) to diagnose patients with AD at high cardiovascular risk. In total, 99.0% prescribed a fibrate to reduce triglyceride levels, 47.4% to increase HDL-C levels and 40.2% to reduce small, dense low-density lipoprotein cholesterol particles.
Since adherence to clinical guidelines improves both the quality of care and health outcomes, greater adherence to and satisfaction with clinical guidelines for the management of AD may contribute to improvements in and optimization of the management of patients with AD in the Spanish health system.
The authors acknowledge the physicians who participated in this study. They also acknowledge Mariona Lería (Medical Department Head/Product Safety & Risk Management) and Outcomes’10 for support with the study coordination.
Compliance with ethical standards
Data confidentiality of all participants was respected at all times. Information about the identity of the participants was considered confidential for all intents and purposes and was stored and handled in accordance with Organic Law 15/1999 of 13 December 1999 on the Protection of Personal Data.
All study participants received adequate information and agreed to participate before inclusion.
This study was sponsored by BGP Product Operations S.L (Mylan).
Conflict of interest
JMNC has no conflicts of interest that are directly relevant to the content of this article. PRF, MMK, MRM and MLOP work at BGP Product Operations S.L (Mylan). SA works for an independent research organization (Outcomes’10, S.L.), which has received fees for contributions to the development and coordination of the project and to the writing of this manuscript.
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