Patient and Physician Reported Perception on Hypercholesterolemia Management in Primary Prevention in Germany: Results from a Nationwide Online Survey

Abstract

Introduction Effective hypercholesterolemia management is essential in primary prevention of cardiovascular events. The objective of PROCYON was to assess the perception on hypercholesterolemia management in primary prevention and to identify reasons for insufficient target attainment in clinical practice in Germany. Methods PROCYON was a two-part online survey including a patient questionnaire on treatment status and disease knowledge and a physician questionnaire on guideline awareness and patient management. A conjoint analysis on the relative importance of cardiovascular risk factors was incorporated. Results Of 3798 primary prevention patients included, 1632 (43.0%) received lipid-lowering medication. Of these, 790 (48.4%) reported improved low-density lipoprotein cholesterol (LDL-C) levels, 670 (41.1%) reported no improvement, and 172 (10.5%) had no information. Of the treated patients with ( N ′ = 790) and without ( N ′ = 670) improvement, 52.4% vs. 47.9% were on their initial drug and dose, 8.9% vs. 9.0% received multiple drug therapy, 34.7% vs. 38.8% reported a dose change, and 16.0% vs. 19.4% had discontinued at least one drug (multiple answers). In total, 109 physicians participated. In the conjoint analysis, LDL-C level was attributed the highest relative importance (32.0%), followed by diabetes (24.5%) and systolic blood pressure (15.8%). Lipid-lowering therapy is initiated at an LDL-C level > 150 mg/dl by 63 physicians (57.8%). One third ( n = 35; 32.1%) stated that ≥ 60% of their primary prevention patients do not receive lipid-lowering medication. Conclusion PROCYON suggests a need for consequent LDL-C target-based treatment implementation. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02266-3.

Different Perspectives of Patients and Physicians on LDL-C Target Achievement in the Treatment of Hypercholesterolemia: Results on Secondary Prevention from the German PROCYON Survey

“…In total, 109 physicians participated in the survey. Characteristics, details on medical experience and responsibilities, and results regarding general awareness of LDL-C importance have been published previously [ 8 ].…”

“…Routine screening for early detection of hypercholesterolemia has to be followed by effective primary prevention. Previously published results of PROCYON on primary prevention have identified issues in this area [ 8 ].…”

“…Limitations of the survey have been described previously [ 8 ]. Shortly, except for PAM-13, no validated questionnaire was available to support the study objective.…”

“…PROCYON was a two-part online survey on disease perception, awareness, burden, and management of hypercholesterolemia consisting of a patient survey and a physician survey. Details on inclusion criteria, patient and physician recruitment, and the questionnaires have been published previously [ 8 ].…”

“…The present survey aimed to identify possible reasons for insufficient target attainment in hypercholesterolemia management in secondary prevention patients in Germany. Results of a primary prevention population have been published previously [ 8 ].…”