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The association between low-density lipoprotein cholesterol goal attainment, physician and patient attitudes and perceptions, and healthcare policy.

Abstract：

AIM:Withholding effective treatment is clinically prevalent. The CEntralized Pan-Asian survey on tHE Under-treatment of hypercholeSterolemia (CEPHEUS-PA) indicated suboptimal low-density lipoprotein cholesterol (LDL-C) goal attainment in Taiwan, which may be attributable to clinical inertia. We herein analyzed the Taiwanese cohort in the CEPHEUS-PA to identify key elements regarding clinical inertia and unsatisfactory LDL-C control. METHODS:A questionnaire regarding the attitudes and perceptions for each physician and patient was included in the CEPHEUS-PA. Physicians completed the physician questionnaire before enrolling patients, who completed the patient questionnaire before the assessment. RESULTS:The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guideline was used by 81.8% of physicians to establish the individual therapeutic targets; 50.2% of patients failed to take medications persistently. Regarding perceptions to hypercholesterolemia management, 75.9% of physicians were confident of having a sufficient number of patients at cholesterol targets; 80.2% and 65.9% of patients felt satisfied and motivated, respectively, but 46.0% had no strong feeling. The healthcare reimbursement policy used for treatment guidance was a significant determinant for LDL-C goal attainment (OR=0.32, 95% CI: 0.15-0.69, P=0.006) in addition to patient compliance. Low patient involvement indexed by having no strong feeling was associated with poor LDL-C control (OR=0.73, 95% CI: 0.56-0.95, P=0.020). CONCLUSIONS:The referenced healthcare reimbursement policy, poor patient compliance, and low patient involvement with hypercholesterolemia management were associated with failure of LDL-C control. Our findings highlight the need to overcome those barriers to improve the under-treatment of hypercholesterolemia.

journal_name

J Atheroscler Thromb

journal_title

Journal of atherosclerosis and thrombosis

authors

Wang KL,Wu CH,Wang KF,Chang CC,Chen LC,Lu TM,Lin SJ,Chiang CE

doi

10.5551/jat.24158

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

1044-54

issue

eissn

1340-3478

issn

1880-3873

pii

DN/JST.JSTAGE/jat/24158

journal_volume

pub_type

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The association between low-density lipoprotein cholesterol goal attainment, physician and patient attitudes and perceptions, and healthcare policy.