Adherence to Current Lipid Guidelines by Physicians in Kuwait

Abstract

Background: Alarmingly high rates of dyslipidemia have been found in the Gulf region in patients presenting with acute coronary syndrome, with the highest being found in Kuwait (37%). Therefore, it is of utmost importance to treat dyslipidemia promptly and effectively. In an effort to understand the practices of local physicians, the use of evidence-based medicine, and adherence to lipid treatment guidelines, the objective of this study was to survey and assess the current standards of care. Methods: A survey questionnaire, designed to assess physicians’ attitudes and practice towards lipid guidelines, was completed by 279 participants and returned between October 2015 and June 2016. Statistical analysis was done using SPSS. Results: Over 90% of physicians claimed to use lipid guidelines, with the majority rating themselves as knowledgeable. Younger physicians were found to be less knowledgeable and consequently used guidelines less frequently. The most important factor influencing clinical decision-making was the availability of clinical guidelines. The majority (72.4%) of physicians identified time limitation as a key barrier. The most commonly selected lipid guideline in daily practice was a guideline on the treatment of blood cholesterol published by the American College of Cardiology/American Heart Association in 2013. The most common risk assessment tool used was the Framingham risk score. Conclusions: Multiple interventions to improve guideline adherence are proposed in this study. We have taken into account the barriers to adherence, i.e., attitude, behavior, and (most importantly) knowledge, all 3 of which were reaffirmed in our investigation in Kuwait.