Have the Government's prescription algorithm and the 2013 American College of Cardiology/American Heart Association guidelines for managing dyslipidemia influenced the management of dyslipidemia? The MEJORALO-CV Project

• Published in: Revista clínica espanõla (English edition) 2020-06, Vol.220 (5), p.282-289
• Main Authors: Giner Galvañ, V., Bonig Trigueros, I., Fácila Rubio, L., Morillas Blasco, P., Martínez Hervás, S., Pascual Fuster, V., Valls Roca, F., Soler Portmann, C., Tamarit García, J.J., Pallarés Carratalá, V., Cepeda Rodrigo, José María, Cosín Sales, Juan, Durá Belinchón, Rafael, Gómez Segado, Enrique, Monleón Arenós, Saray, Morillas Ariño, Carlos, Rodilla Sala, Enrique, Rovira Daudí, Eduardo, Vicente Navarro, David
• Format: Article
• Language: English
• Subjects: Atención primaria; Clinical practice guidelines; Dislipemia; Dyslipidemia; Estatinas; Guía de práctica clínica; Primary care; Statins
• ISSN: 2254-8874; 2254-8874
• DOI: 10.1016/j.rceng.2019.08.006

To determine the management of dyslipidemia in primary care after the publication of the American College of Cardiology/American Heart Association (ACC/AHA) 2013 guidelines and Valencian government's algorithm. We conducted a cross-sectional descriptive study that employed a survey of primary care physicians of the Community of Valencia between January and October 2016. A total of 199 physicians (mean age, 48.9±11.0 years; experience, 21.3±11.1 years) participated in the survey. The most followed guidelines were those of the European Society of Cardiology (37.5% of respondents) and Valencian government (23.4% of respondents). Some 6.3% of the respondents followed the 2013 ACC/AHA guidelines, and 88.0% established objectives based on LDL cholesterol and cardiovascular risk. The choice of lipid-lowering drug was based on its LDL cholesterol lowering capacity (28.6% of respondents), on the Valencian government's algorithm (23.4%) and on the drug's safety (20.4%). Statins, ezetimibe and fibrates were the preferred hypolipemiant agents, and their combination (51% of respondents) and dosage increases (35%) were the strategies employed for poor control. Lipid profile and transaminase and creatine kinase levels were measured every 6 (59.5%, 52.3% and 54.3% of respondents, respectively) or 12 months (25.1%, 29.2% and 30.3%, respectively). Forty-one percent of the respondents were aware of the controversy surrounding the 2013 ACC/AHA guidelines. Although 60% of the respondents acknowledged its relevance, only 21% changed their daily practices accordingly. The Valencian government's algorithm had a greater impact than the 2013 ACC/AHA guidelines in primary care in Valencia. Areas for improvement included the low use of validated guidelines and risk tables and the streamlining of laboratory test periodicity. Conocer el manejo de la dislipemia en atención primaria tras la publicación de la Guía de la American College of Cardiology/American Heart Association (ACC/AHA) del año 2013 y el algoritmo de la Administración. Estudio transversal descriptivo con encuesta a médicos de atención primaria de la Comunidad Valenciana entre enero y octubre de 2016. Participaron 199 facultativos con una media (desviación típica) de 48,9 (11) años de edad y 21,3 (11,1) años de experiencia. Las guías más seguidas eran las de la European Society of Cardiology (37,5%) y las de la Administración (23,4%). El 6,3% seguía la de la ACC/AHA 2013. El 88% establecía objetivos según colesterol LDL y