The gap between dyslipidemia control perceived by physicians and objective control patterns in Spain.
OBJECTIVE
It is well-known that adequate control of dyslipidemia is low. But little is known about how well physicians perceive the control of their dyslipidemic patients. This study examines physicians' subjective perception of dyslipidemia control, and compares it with control determined objectively with published guidelines.


METHODS
A total of 33,913 patients were studied cross-sectionally in 164 Spanish outpatients' clinics. Of these patients, 5583 were evaluable patients with a documented diagnosis of dyslipidemia. Control of dyslipidemia was evaluated by two methods: the physician's opinion on their patient's lipid levels (adequate control or inadequate control), and the proportion of patients who objectively reach the LDL-cholesterol goals of the National Cholesterol Education Program (NCEP/ATPIII).


RESULTS
Physicians perceived that 44% (95% CI 42.7-45.3%) of their patients had an adequate control of their dyslipidemia, but only 32.8% (95% CI 31.6-34.0%) were objectively controlled. Subjective control hardly changed across the NCEP cardiovascular risk groups, but objective control was lower in the 2372 coronary heart disease patients (15.1%) and in the 1407 moderately high-risk patients (29.6%) than in the 1804 lower risk patients (58.5%). Physicians' perception of control was significantly and independently associated with objective control (P<0.001).


CONCLUSIONS
Physicians overestimate dyslipidemia control in the majority of their patients. Misperception of control by physicians may contribute to the low achievement of objective control.
Banegas
José R
JR
Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo s/n, 28029 Madrid, Spain. joseramon.benegas@uam.es
Vegazo
Onofre
O
Serrano
Pedro
P
Luengo
Emilio
E
Mantilla
Teresa
T
Fernández
Raúl
R
Civeira
Fernando
F
D000554:Ambulatory Care Facilities; D001291:Attitude of Health Personnel; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000517:prevention & control*; D006801:Humans; D016015:Logistic Models; D010820:Physicians / Q000523:psychology*; D017410:Practice Guidelines as Topic; D013030:Spain; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D008078:Cholesterol, LDL