Current status of cholesterol goal attainment after statin therapy among patients with hypercholesterolemia in Asian countries and region: the Return on Expenditure Achieved for Lipid Therapy in Asia (REALITY-Asia) study

Kim, Hyo–Soo; Wu, Yangfeng; Lin, Shing‐Jong; Deerochanawong, Chaicharn; Zambahari, Robaayah; Zhao, Liyan; Zhang, Qiaoyi; Yan, Peter

doi:10.1185/03007990802138731

Cited by 66 publications

(60 citation statements)

References 35 publications

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“…LDL-C after 12 months 17) . However, the Lipid Treatment Assessment Project 2 (L-TAP2) study 19) , reported a higher rate of LDL-C goal attainment than the combined CEPHEUS studies.…”

Section: Discussionmentioning

confidence: 99%

“…Statins are the mainstay of lipid-lowering drug (LLD) therapy and have been shown to reduce both LDL-C levels and CV risk in clinical trials [9][10][11][12][13][14][15][16] . Despite the significant increase in the number of patients treated with statins and other LLDs over the past decade, surveys have shown that relatively few individuals eligible for treatment attain their recommended LDL-C level [17][18][19] . …”

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confidence: 99%

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Suboptimal Control of Lipid Levels: Results from 29 Countries Participating in the Centralized Pan-Regional Surveys on the Undertreatment of Hypercholesterolaemia (CEPHEUS)

Chiang

Ferrières

Gotcheva

et al. 2016

J Atheroscler Thromb

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. Epidemiological studies have shown that elevated serum lipid and low-density lipoprotein 568 CEPHEUS studies were conducted in 29 countries across Asia (Hong Kong, Indonesia, Malaysia, Philippines, South Korea, Taiwan, Thailand, and Vietnam) 23,26) , Western Europe (Belgium, Finland, France, Greece, Ireland, Luxembourg, Netherlands, and Turkey) 22,27,28) , Eastern Europe (Bulgaria, Poland, and Russia) 20) , the Middle East (United Arab Emirates, Bahrain, Jordan, Kuwait, Oman, Qatar, and Saudi Arabia) 21,25) , and Africa (Algeria, Egypt. and South Africa) 24) . In each country, the study protocol was reviewed and approved by the Institutional Review Board and Ethics Committee governing each participating center. The surveys were performed in accordance with the Declaration of Helsinki and the International Conference on Harmonisation guidelines for Good Clinical Practice 29) , and all participating patients provided written informed consent before enrolment.Each survey was a single-visit study and recruitment was carried out in two stages. In the first stage, physicians with experience of treating dyslipidaemia were invited to participate. Physicians who agreed to participate were asked to complete a questionnaire about their general attitude toward the diagnosis of hypercholesterolaemia, their perception of existing guidelines, and their knowledge about available treatment options (Supplemental Fig. 1). In the second stage, eligible patients who attended a regular scheduled physician visit were consecutively invited to participate in the study. Patients were eligible to participate if they were ≥ 18 years and had been receiving LLDs for at least 3 months without dose changes for at least 6 weeks. Patients were excluded if they were found to have participated in any interventional clinical study in the preceding 90 days, were unable or unwilling to provide informed consent, or were personally involved in the conduct of the surveys. In all countries except France, before being assessed by the physician, patients also completed a questionnaire, the aim of which was to assess their personal perception of hypercholesterolaemia, their current LLD regimen, their adherence to this regimen, and their satisfaction with the treatment (Supplemental Fig. 2).For each individual, physicians also completed a patient record form, which included information on the patient's demographics, current LLD therapy, and reason for initiating LLD therapy. Physicians also recorded the presence of known CV risk factors, such as smoking, diabetes mellitus, family history of premature coronary heart disease (CHD; defined as having a first-degree relative with clinical CHD or sudden death before the age of 55 years for men or 65 years for women), hypertension (defined as blood pressure cholesterol (LDL-C) levels, in particular, are strongly associated with an increased risk of incident CV disease in many populations worldwide 3, 4) . Most guidelines include the reduction of LDL-C levels as a primary therapeutic target for the reduction o...

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“…LDL-C after 12 months 17) . However, the Lipid Treatment Assessment Project 2 (L-TAP2) study 19) , reported a higher rate of LDL-C goal attainment than the combined CEPHEUS studies.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Suboptimal Control of Lipid Levels: Results from 29 Countries Participating in the Centralized Pan-Regional Surveys on the Undertreatment of Hypercholesterolaemia (CEPHEUS)

Chiang

Ferrières

Gotcheva

et al. 2016

J Atheroscler Thromb

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“…[13][14][15][16][17] Similarly, a study of dyslipidaemia management in South Asia including China, South Korea, Malaysia, and Singapore revealed that only 48% of patients attained pre-defined low-density lipoprotein-cholesterol goals. 18 Similar to other chronic conditions, the reasons for poor (lipid) control are multifactorial and may include patient, physician, and health care delivery factors. Among them, suboptimal medication augmentation has been identified as an important physician factor.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic inertia in the management of hyperlipidaemia in type 2 diabetic patients: a cross-sectional study in the primary care setting

Man¹,

Chen²,

Lau³

et al. 2016

Hong Kong Med J

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Objectives:To study the prevalence of therapeutic inertia in lipid management among type 2 diabetic patients in the primary care setting and to explore associated factors.Methods: This was a cross-sectional study involving type 2 diabetic patients with suboptimal lipid control followed up in all general out-patient clinics of Kowloon Central Cluster in Hong Kong from 1 October 2011 to 30 September 2013. Main outcome measures included prevalence of therapeutic inertia in low-density lipoprotein management among type 2 diabetic patients and its association with patient and physician characteristics.Results: Based on an agreed standard, lipid control was suboptimal in 49.1% (n=9647) of type 2 diabetic patients who attended for a regular annual check-up (n=19 662). Among the sampled 369 type 2 diabetic patients with suboptimal lipid control, therapeutic inertia was found to be present in 244 cases, with a prevalence rate of 66.1%. When the attending doctors' profiles were compared, the mean duration of clinical practice was significantly longer in the therapeutic inertia group than the non-therapeutic inertia group. Doctors without prior training in family medicine were also found to have a higher rate of therapeutic inertia. Patients in the therapeutic inertia group had Therapeutic inertia in the management of hyperlipidaemia in type 2 diabetic patients: a cross-sectional study in the primary care setting

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“…The National Health Insurance (NHI), as the backbone of the healthcare system in Taiwan, provides universal medical coverage for beneficiaries (＞99% of the population) with a small portion paid by the users; therefore, financial concerns may not be a major issue. However, the under-treatment of hypercholesterolemia in Taiwan was more prevalent compared with other Asian countries 4,6,7) . Because enhanced prescription coverage has been shown to improve medication persistence and to reduce vascular events 17) , such discrepancy occurring in a population that is well covered by the healthcare insurance program may largely reflect a lack of awareness and poor compliance.…”

Section: Characteristics Of Physicians and Practicementioning

confidence: 99%

“…Despite the treatment benefits demonstrated by clinical trials and therapeutic targets advocated by academic societies, the majority of patients fail to achieve the LDL-C targets recommended by the practicing guidelines, particularly in the high-risk patients [4][5][6] . Suboptimal control is directly related to the risk level of individual patients, including the target set accordingly and the baseline LDL-C level 6,7) , and inadequate pharmacological treatment, including under-prescription 8) , inappropriate dosing and potency 9) , and non-compliance of both patients and physicians [5][6][7] . In addition to patient characteristics and compliance to lipid-lowering medications, physician characteristics and the administration policy were also associated with under-treatment and non-treatment [10][11][12] .…”

Section: Characteristics Of Physicians and Practicementioning

confidence: 99%

The Association between Low-Density Lipoprotein Cholesterol Goal Attainment, Physician and Patient Attitudes and Perceptions, and Healthcare Policy

Wang

et al. 2014

JAT

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Current status of cholesterol goal attainment after statin therapy among patients with hypercholesterolemia in Asian countries and region: the Return on Expenditure Achieved for Lipid Therapy in Asia (REALITY-Asia) study

Cited by 66 publications

References 35 publications

Suboptimal Control of Lipid Levels: Results from 29 Countries Participating in the Centralized Pan-Regional Surveys on the Undertreatment of Hypercholesterolaemia (CEPHEUS)

Suboptimal Control of Lipid Levels: Results from 29 Countries Participating in the Centralized Pan-Regional Surveys on the Undertreatment of Hypercholesterolaemia (CEPHEUS)

Therapeutic inertia in the management of hyperlipidaemia in type 2 diabetic patients: a cross-sectional study in the primary care setting

The Association between Low-Density Lipoprotein Cholesterol Goal Attainment, Physician and Patient Attitudes and Perceptions, and Healthcare Policy

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