Abstract:
BACKGROUND:Despite clinical guidelines, many patients with hypercholesterolemia do not achieve treatment goals in clinical practice. OBJECTIVES:This study examined physician attitudes and beliefs about hyperlipidemia and whether they are associated with lipid treatment decisions. METHODS:This was a cross-sectional study of 107 physicians who completed a validated survey of attitudes and beliefs about hyperlipidemia and provided treatment histories for 1187 statin-treated patients with coronary heart disease (CHD) or who were CHD risk-equivalent. Logistic regressions (using generalized estimating equation) estimated the impact of patient characteristics and physician attitudes and beliefs on whether a patient received increases in the statin dose. RESULTS:Approximately 70% of the 843 patients who were not at low-density lipoprotein cholesterol goal (<100 mg/dL) with initial statin therapy received a dose increase, although only one-half attained goal. Controlling for patient characteristics, patients whose physicians believed "close enough to goal is good enough" had 47% lower odds of having a dose increase (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.34-0.82), whereas patients whose physicians believed "statins are effective" had almost twice the odds of having a dose increase (OR, 1.78; 95% CI, 1.05-3.00). CONCLUSIONS:Although the understanding of basic and clinical science remains fundamental, clinical guideline authors may want to consider the importance of physician attitudes and beliefs in determining translation of their guidelines into clinical practice.
journal_name
Med Carejournal_title
Medical careauthors
Foley KA,Denke MA,Kamal-Bahl S,Simpson R Jr,Berra K,Sajjan S,Alexander CMdoi
10.1097/01.mlr.0000208017.18278.1asubject
Has Abstractpub_date
2006-05-01 00:00:00pages
421-8issue
5eissn
0025-7079issn
1537-1948pii
00005650-200605000-00006journal_volume
44pub_type
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