Determination of non-treatment with statins of high risk patients in the Netherlands

Haak, Pieter van den; Heintjes, Edith M.; Plat, Arian W.; Meerding, Willem Jan; Webb, Kate; Sturkenboom, Miriam; Herings, Ron M. C.

doi:10.1185/03007990903435184

Cited by 7 publications

(9 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both the CEPHEUS 4 and van den Haak et al 5 studies, as well as previous research, identified key issues in the management of hypercholesterolemia. The underprescription of statins, discontinuation of statins, and poor adherence to prescribed statins are all issues that can be improved by ensuring that patients are well informed and that physicians are kept up to date regarding current guidelines.…”

mentioning

confidence: 93%

“…This shows that increased awareness has a positive impact on patient treatment. However, despite these positive changes, van den Haak et al 5 have shown that treatment is still suboptimal and a number of high-risk patients are not prescribed statins.…”

mentioning

confidence: 97%

“…These are encouraging results; however, while patients often do not heed the advice of their physician, it is important to understand that physicians may withdraw statin treatment without proper justification. It is clear from van den Haak et al that a large number of patients who should be treated with statins are never given a prescription 5 . This is less likely to happen in large hospitals or academic centres and underscores the importance of increasing physician awareness with respect to treatment guidelines and achieving target LDL-C goals 39,40 .…”

mentioning

confidence: 98%

“…However, despite these benefits, statins are both under-prescribed and under-adhered to in clinical practice 2,3 . In this issue of Current Medical Research and Opinion two studies document the under-prescription of statins and the under-treatment of hypercholesterolemia 4,5 .…”

mentioning

confidence: 99%

See 3 more Smart Citations

Undertreatment of hypercholesterolemia

Daskalopoulou

Doonan

Mikhailidis

2009

Current Medical Research and Opinion

View full text Add to dashboard Cite

Recent guidelines recommend strict goals for low-density lipoprotein cholesterol (LDL-C) (1.8-2.6 mmol/L; 70-100 mg/dL). However, these goals are not always met and many primary and secondary prevention patients are not optimally controlled. Both the under-prescription of lipid-lowering medication and lack of adherence to prescribed medications could account for this situation. In this issue of the journal, two studies evaluated the under-treatment of hypercholesterolemia in European countries, as well as patient/physician characteristics that are related to poor control of LDL-C. This editorial considers the implications of these findings. While we have come far in recent years in terms of treating hypercholesterolemia, we still have considerable room for improvement and progress towards evidence-based clinical practice.

show abstract

mentioning

confidence: 93%

mentioning

confidence: 97%

mentioning

confidence: 98%

mentioning

confidence: 99%

See 2 more Smart Citations

Undertreatment of hypercholesterolemia

Daskalopoulou

Doonan

Mikhailidis

2009

Current Medical Research and Opinion

View full text Add to dashboard Cite

show abstract

“…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] . Withholding effective treatment both from the patient and physician perspectives, referred to clinical inertia, is common in the management of chronic medical conditions 13,14) .…”

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

View full text Add to dashboard Cite

show abstract

Lipid-lowering therapy for primary prevention of premature atherosclerotic coronary artery disease: Eligibility, utilization, target achievement, and predictors of initiation

Vikulova

Skorniakov

Bitoiu

et al. 2020

American Journal of Preventive Cardiology

View full text Add to dashboard Cite

Objectives Despite advances in screening and prevention, rates of premature coronary artery disease (CAD) have been stagnant. The goals of this study were to investigate the barriers to early risk detection and preventive treatment in patients with premature CAD. In particular, we: 1) assessed the performance of the latest versions of major international guidelines in detection of risk of premature CAD and eligibility for preventive treatment; and, 2) investigated real-life utilization of primary prevention with lipid-lowering therapies in these patients. Methods We included patients in the Study to Avoid cardioVascular Events in British Columbia (SAVE BC), an observational study of patients with premature (males ≤ 50 years, females ≤ 55 years) angiographically confirmed CAD. Eligibility for primary prevention and treatment received were assessed retrospectively based on information recorded prior to or at the index presentation with CAD. Results Of 417 patients (28.1% females) who met the criteria, 94.3% had at least one major cardiovascular risk factor. In the retrospective risk assessment, 41.7%, 61.4%, and 34.3% (p < 0.001) of patients met criteria for initiation of statin therapy, and an additional 13.9%, 8.4%, and 46.8% may be considered for treatment using the American College of Cardiology/American Heart Association, Canadian Cardiovascular Society, and European Society of Cardiology guidelines, respectively. Only 17.1% of patients received statins and 11.0% achieved guideline-recommended lipid goals before presentation. Diabetes and elevated plasma lipid levels were positively associated with treatment initiation, while smoking was associated with non-treatment. Conclusions The current versions of major guidelines fail to recognize many patients who develop premature CAD as being at risk. The vast majority of these patients, including patients who have guideline-directed indications, do not receive lipid-lowering therapy before presenting with CAD. Our findings highlight the need for more effective screening and prevention strategies for premature CAD .

show abstract

Determination of non-treatment with statins of high risk patients in the Netherlands

Cited by 7 publications

References 16 publications

Undertreatment of hypercholesterolemia

Undertreatment of hypercholesterolemia

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

Lipid-lowering therapy for primary prevention of premature atherosclerotic coronary artery disease: Eligibility, utilization, target achievement, and predictors of initiation

Contact Info

Product

Resources

About