[Medical guidelines and medical practices: The example of lipid lowering therapy].
BACKGROUND
The SPOT epidemiologic survey assessed the results of long-term cholesterol-lowering therapy in France and the reasons why patients do or do not meet their therapeutic objectives.


OBJECTIVE
To assess the guidelines on which doctors base their practices for cholesterol-lowering therapy and make suggestions to improve the match between recommendations and practices.


METHODS
LDL cholesterol was measured in 2479 French outpatients in 2003 and classified according to whether it met therapeutic objectives of 3 different scales: the official French (AFSSAPS) recommendations issued in 2000, the physician's opinion of the ideal level for the patient, and the physician's goal level for the patient. Agreement between these 3 criteria was analyzed.


RESULTS
French doctors used guidelines stricter than the official recommendations to assess the achievement of lipid-lowering objectives.


CONCLUSIONS
Physicians rely more on American than French guidelines. They also considered the patient's history and clinical condition in setting individual goals.
Grondin
Marie-Ange
MA
Unité épidémiologie, économie de la santé et prévention, Délégation qualité, Département de santé publique, Hôtel-Dieu, Clermont-Ferrand (63). M.Ange.GRONDIN@u-clermont1.fr
Ouchchane
Lemlih
L
Ferrières
Jean
J
Gerbaud
Laurent
L
D001291:Attitude of Health Personnel; D008078:Cholesterol, LDL / Q000097:blood; D005602:France; D019983:Guideline Adherence; D006801:Humans; D006949:Hyperlipidemias / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'
D008078:Cholesterol, LDL