[Changes in biological test practices after publication of national guidelines for lipid management among patients under statin treatment].
BACKGROUND
Guidelines for screening and treatment of dyslipidemia were disseminated in September and October 2000 by the National Agency of Accreditation and of Evaluation in Health (ANAES) and the French Agency of Medical Safety of the Products of Health (AFSSAPS). It was confirmed that the specific biological test was the measurement of LDL Cholestérol.


OBJECTIVE
To study changes in biological test practices after diffusion of guidelines among patients on statin therapy, using Health Insurance database on reimbursement of patients living in Ile-de-France region (8,534,623 social insurance contributors).


METHODS
Two groups of patients were defined in the database from the codes for medication refunds during one month (March 2000 and March 2002). The first group named "new users" included patients starting statin therapy in March, in order to follow the biological test for screening. The second group named "long term users" included patients who had been treated by statin therapy for one year or more, in order to examine the biological follow-up of treatment. All lipid biological tests were recorded during one year, before March 2000 and March 2002. Changes in medical practices were noted as the percentage of the biological tests for "exploration of a lipidic anomaly" (EAL) with determination of LDL cholesterol.


RESULTS
For new users the percentage of patients having had at least one EAL for screening purposes increased by 13.5 (39.9% in 2000 and 53.4% en 2002). For long term users the change was + 21.1 (38.3% in 2000 and 59.4% in 2002) during follow-up.


CONCLUSIONS
An improvement in biological testing practices was noted after diffusion of guidelines.
Chevalier
C
C
Médecin-conseil, Service Medical de l'Assurance-Maladie d'Ile-de-France, CNAMTS, 173, rue de Bercy, 75586 Paris Cedex. christine.chevalier@elsm-paris.cnamts.fr
Giral
P
P
Oger
C
C
Costedoat-Rouchet
G
G
Carzon
M
M
Trutt
B
B
D050171:Dyslipidemias / Q000097:blood* / Q000188:drug therapy; D019983:Guideline Adherence; D006403:Hematologic Tests / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors