General practitioners' adherence to guidelines on management of dyslipidaemia: ADDITION-Denmark.
OBJECTIVE
To describe the management of dyslipidaemia in patients with high risk of cardiovascular disease (CVD) and patients with a history of CVD identified by screening for diabetes in general practice in Denmark, concentrating on prescription of lipid-lowering drugs. Moreover, to analyse predicting factors for starting lipid-lowering drugs related to patient and general practice characteristics.


METHODS
Population-based cross-sectional study with follow-up.


METHODS
A total of 139 general practices from three of five Danish regions, totalling 216 GPs.


METHODS
The study population comprised 4986 patients with a high risk of CVD and dyslipidaemia and 764 patients with a history of CVD and dyslipidaemia out of a population of 16 572 patients who completed screening for diabetes but were cleared for diabetes in the ADDITION study.


RESULTS
Of patients with a high risk of CVD and dyslipidaemia not receiving lipid-lowering drugs at the time of screening (n = 4823), 20% started lipid-lowering therapy within the follow-up period (median 2.1 years). This percentage was 45% (n = 536) for patients with CVD and dyslipidaemia (median follow-up period 1.6 years). Age over 50, high cholesterol, impaired fasting glucose and/or impaired glucose tolerance, minor polypharmacy, use of heart/circulation drugs, and cholesterol measurements after screening predicted the prescription of lipid-lowering drugs for patients at high risk of CVD. For patients with CVD, male gender, high cholesterol and use of heart/circulation drugs predicted the prescription of lipid-lowering drugs. No general practice characteristics were associated with different prescription habits.


CONCLUSIONS
There is a gap between the recommended lipid-lowering drug therapy and current practice, with a substantial under-treatment and a considerable delay in the first prescription of lipid-lowering drugs.
Graversen
Lise
L
Department of General Practice, School of Public Health. University of Aarhus, Bartholins Allé 2, 8000 Aarhus C, Denmark. lgra@alm.au.dk
Christensen
Bo
B
Borch-Johnsen
Knut
K
Lauritzen
Torsten
T
Sandbaek
Annelli
A
D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D003718:Denmark; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy*; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012307:Risk Factors
D000960:Hypolipidemic Agents