Lipid management in India: a nationwide, cross-sectional physician survey
| Autor: | Gurpreet Singh Wander, Uday Jadhav, Jaideep Gogtay, Meena Lopez, Amruta Chemburkar |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Statin medicine.drug_class Endocrinology Diabetes and Metabolism Atorvastatin Clinical Biochemistry India 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Endocrinology Pharmacotherapy Ezetimibe Risk Factors Surveys and Questionnaires Internal medicine medicine Humans Rosuvastatin 030212 general & internal medicine Survey lcsh:RC620-627 Dyslipidemias medicine.diagnostic_test business.industry Research Biochemistry (medical) Hypertriglyceridemia Fibric Acids nutritional and metabolic diseases Lipid Metabolism medicine.disease Lipids lcsh:Nutritional diseases. Deficiency diseases Cross-Sectional Studies Dyslipidemia lipids (amino acids peptides and proteins) Hydroxymethylglutaryl-CoA Reductase Inhibitors Lipid profile business Physician survey medicine.drug |
| Zdroj: | Lipids in Health and Disease, Vol 16, Iss 1, Pp 1-9 (2017) Lipids in Health and Disease |
| ISSN: | 1476-511X |
| Popis: | Background Current international guidelines on dyslipidemia are not concordant on various aspects of management. Also, there are no uniformly accepted Indian guidelines. We, therefore, performed a physician survey to understand lipid management practices in India. Methods An anonymous survey questionnaire was administered to gauge physicians’ self-reported behavior regarding lipid management aspects. Results were expressed in terms of percentages based on the number of responses obtained. Results A total of 404 physicians participated in the survey. Eighty-eight percent respondents ordered a lipid profile before starting statin therapy, and 80% preferred to set lipid targets, though the tools used for calculating cardiovascular risk varied. Atorvastatin was preferred over rosuvastatin in primary prevention (72.9 vs. 32.4%), secondary prevention (54.6 vs. 46.7%), diabetic patients (56.3 vs. 40.3%) and post-ACS (78.3 vs. 34%). High-intensity statins were preferred by 73.7% of respondents in post-ACS cases. Fifty percent doctors chose not to use a statin in diabetic patients, irrespective of their LDL-C levels. The most preferred drug option for managing atherogenic dyslipidemia and moderate hypertriglyceridemia was statin-fibrate combination (55.1%) and fibrates (35.4%), respectively. Sixty-three percent doctors preferred to prescribe statins in patients with moderately high LDL-C and normal triglycerides, without CHD or CHD risk equivalents. Around 28% of doctors preferred not to use pharmacotherapy for managing isolated low HDL. Of the participants, 73% used fibrates in ≤20% of their dyslipidemic patients, with fenofibrate being the most preferred (90.5%). Ezetimibe was mainly used in patients with uncontrolled LDL-C despite statin therapy (52.4% respondents). Most preferred approaches to manage statin intolerance included reducing statin dose (39%) and stopping and restarting statins at a lower dose (34.5%). Fifty-two percent of doctors chose not to alter pre-existing therapy in patients who had LDL-C levels at goal but elevated non-HDL-C levels. Conclusion This is the first survey in India that provides useful insights into Indian physicians’ self-reported perspectives on managing dyslipidemia in routine clinical practice. Despite concordance with the currently available guidelines in certain aspects, there is incongruence in managing specific dyslipidemia problems. Further continuing medical education and the development of evidence-based, India-specific lipid guidelines can help reduce some of these differences. Electronic supplementary material The online version of this article (doi:10.1186/s12944-017-0519-1) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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