Is the Physician’s Behavior in Dyslipidemia Diagnosis in Accordance with Guidelines? Cross-Sectional Escarval Study
| Autor: | Ana María Perez-Navarro, Antonio Palazón-Bru, Domingo Orozco-Beltrán, F. Valls-Roca, Jorge Navarro-Pérez, Vicente Francisco Gil-Guillén, Carlos Sanchis-Domenech, Vicente Pallarés-Carratalá, Elías Ruiz, Jose Luis Trillo, Ruth Uso, Jose M. Martin-Moreno, Josep Redon, Antonio Fernández-Giménez |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Health Screening Non-Clinical Medicine Cross-sectional study Health Care Providers Cardiovascular chemistry.chemical_compound Risk Factors Odds Ratio Practice Patterns Physicians' Young adult Health Systems Strengthening Multidisciplinary Communication Atrial fibrillation Middle Aged Cholesterol Medicine Female lipids (amino acids peptides and proteins) Guideline Adherence Public Health Research Article Adult medicine.medical_specialty Clinical Research Design Science Cardiology Young Adult Diagnostic Medicine Physicians Internal medicine Diabetes mellitus medicine Humans Health Care Quality Aged Dyslipidemias Health Care Policy business.industry Cholesterol HDL Odds ratio medicine.disease Middle age Cross-Sectional Studies chemistry Spain Preventive Medicine business Dyslipidemia |
| Zdroj: | Repositori Universitat Jaume I Universitat Jaume I PLoS ONE, Vol 9, Iss 3, p e91567 (2014) PLoS ONE PLoS One r-FISABIO: Repositorio Institucional de Producción Científica Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante instname r-FISABIO. Repositorio Institucional de Producción Científica |
| ISSN: | 1932-6203 |
| Popis: | Background: Clinical inertia has been defined as mistakes by the physician in starting or intensifying treatment when indicated. Inertia, therefore, can affect other stages in the healthcare process, like diagnosis. The diagnosis of dyslipidemia requires $ 2 high lipid values, but inappropriate behavior in the diagnosis of dyslipidemia has only previously been analyzed using just total cholesterol (TC). Objectives: To determine clinical inertia in the dyslipidemia diagnosis using both TC and high-density lipoprotein cholesterol (HDL-c) and its associated factors. Design: Cross-sectional. Setting: All health center visits in the second half of 2010 in the Valencian Community (Spain). Patients: 11,386 nondyslipidemic individuals aged $ 20 years with $ 2 lipid determinations. Measurement Variables: Gender, atrial fibrillation, hypertension, diabetes, cardiovascular disease, age, and ESCARVAL training course. Lipid groups: normal (TC , 5.17 mmol/L and normal HDL-c [ $ 1.03 mmol/L in men and $ 1.29 mmol/L in women], TC inertia (TC $ 5.17 mmol/L and normal HDL-c), HDL-c inertia (TC , 5.17 mmol/L and low HDL-c), and combined inertia (TC $ 5.17 mmol/L and low HDL-c). Results: TC inertia: 38.0% (95% CI: 37.2–38.9%); HDL-c inertia: 17.7% (95% CI: 17.0–18.4%); and combined inertia: 9.6% (95% CI: 9.1–10.2%). The profile associated with TC inertia was: female, no cardiovascular risk factors, no cardiovascular disease, middle or advanced age; for HDL-c inertia: female, cardiovascular risk factors and cardiovascular disease; and for combined inertia: female, hypertension and middle age. Limitations: Cross-sectional study, under-reporting, no analysis of some cardiovascular risk factors or other lipid parameters. Conclusions: A more proactive attitude should be adopted, focusing on the full diagnosis of dyslipidemia in clinical practice. Special emphasis should be placed on patients with low HDL-c levels and an increased cardiovascular risk. |
| Databáze: | OpenAIRE |
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