Concordance with the 2016 RCPT clinical practice guideline on pharmacologic therapy of dyslipidemia for atherosclerotic cardiovascular disease prevention
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Abstract
The use of lipid lowering drugs, especially statins for primary and secondary prevention, can reduce the risk of cardiovascular events. Previous studies had demonstrated that most of the patients did not reach the target levels of LDL-C according to international guidelines recommendations. However, no study demonstrated the prescription of lipid lowering drug therapy and the achievement of target LDL-C levels according to the Royal College of Physicians of Thailand (RCPT) guideline. Objective: 1) to evaluate the concordance of lipid lowering drugs therapy according to the RCPT guideline and 2) to evaluate the achievement of target LDL-C levels in treated patients. Methods: Data were collected from medical records of outpatients at risk of cardiovascular disease and should receive a statin (primary prevention) and those with established cardiovascular disease (secondary prevention) at Maharaj Nakorn Chiang Mai Hospital between January 1 and December 31, 2018. Data were analyzed using descriptive statistics. Results: A total of 279 patients were included: 79 patients with primary prevention (mean age: 57.7±14.9 years) and 200 patients with secondary prevention (mean age: 64.6±11.6 years). The concordance of statin prescriptions were 51.9% for primary prevention and 93.0% for secondary prevention. In the meantime, 81.0% and 49.2% of the patients who received a statin for primary and secondary prevention, respectively, achieved LDL-C target levels. Conclusion: More than half of statin prescriptions for primary prevention were consistent with RCPT guideline. Among patients taking the statin for primary prevention, most of them reached the target levels of LDL-C. On the other hand, among patients taking the statin for secondary prevention, most of them did not reach the LDL-C target levels even though most statin prescriptions were consistent with RCPT guideline.
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