title: Statins are less effective in common daily practice among patients with hypercholesterolemia: the REALITY-PHARMO study.
abstract: BACKGROUND
  To study the use and effectiveness of lipid-lowering drugs with respect to lowering of cholesterol levels in routine daily practice.
  
  
  METHODS
  20 392 patients for whom lipid levels records were available between January 1991 and December 2001 were included in this retrospective population based cohort study. From this group of patients 1899 patients started treatment during the study period and had at least one baseline cholesterol measurement during the six months prior to the initiation of lipid lowering drugs and at least one cholesterol measurement after initiation. A patient was defined to be 'at goal' if the patient had a total cholesterol less than 5.0 mmol/L.
  
  
  RESULTS
  Our results indicate that only 30.2% of all treated patients achieved goal in the first year of treatment. After the introduction of new guidelines in 1998, recommending more aggressive treatment, the goal attainment percentage rose from 22.4% of those patients treated before 1998 to 42.3% for those in whom treatment was initiated after 1998.
  
  
  CONCLUSIONS
  The percentage of patients achieving guideline recommended goal is low in real-life even in patients treated with high dose statins.
authors.affiliation: PHARMO Institute, Utrecht, The Netherlands. wim.goettsch@pharmo.nl
authors.forename: Wim G
authors.initials: WG
authors.lastname: Goettsch
authors.forename: Donald D
authors.initials: DD
authors.lastname: Yin
authors.forename: Evo
authors.initials: E
authors.lastname: Alemao
authors.forename: Olaf H
authors.initials: OH
authors.lastname: Klungel
authors.forename: Anton F
authors.initials: AF
authors.lastname: Stalenhoef
authors.forename: Ron M C
authors.initials: RM
authors.lastname: Herings
mesh_terms: D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol