Impact of physician's perception about LDL cholesterol control in clinical practice when treating patients in Spain

Abstract

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): This work is a study of the Spanish Society of Cardiology and Spanish Society of Atherosclerosis, sponsored by Daiichi Sankyo Spain. Objective To understand the impact of physicians` perception about LDL-cholesterol (LDLc) control on the management of patients with dyslipidemia in Spain. Methods Cross-sectional and multicenter study, in which 435 healthcare professionals from 145 healthcare areas in Spain participated in face-to-face meetings, collecting qualitative and quantitative information related to hypercholesterolemia patients’ management. Additionally, aggregated anonymized data of the last 10 patients with hypercholesterolemia attended by each physician were collected and analyzed with descriptive statistics. Results A total of 4,010 patients (8%, 13%, 16% and 61% with low, moderate, high, and very high cardiovascular [CV] risk) were included. Physicians` perception was that 62% of their patients attained LDLc goals (66%, 63%, 61% and 56%, for low, moderate, high and very high CV risk, respectively). However, when looking into the data only 31% (vs 62% P<0.01) of patients attained the risk-based LDL-C goals (47%, 36%, 22% and 25%, respectively). Overall, 33% of patients were taking high intensity statins, 32% statin/ezetimibe, 21% low/moderate intensity statins and 4% PCSK9 inhibitors. These numbers were 38%, 45%, 8% and 6% for very high CV risk patients and 44%, 21%, 21% and 4% for high CV risk patients, respectively. In only 32% of patients a change in lipid lowering therapy was performed after the visit, mainly combining statins with ezetimibe (55%). The proportion of patients achieving LDL-C goals improved as higher potency lipid-lowering therapy was used (Figure 2). Conclusions In Spain most patients with dyslipidemia do not achieve the recommended LDL-C goals because of an insufficient intensification of lipid lowering therapy, regardless of CV risk, at least in part due to the misperception of physicians about LDL-C control.