The problem of achieving the target concentrations of low density lipoproteins cholesterol in real clinical practice: the data of the survey of doctors of different specialties


DOI: https://dx.doi.org/10.18565/therapy.2021.6.62-71

Rozhkov D.E., Tyrenko V.V., Nikitin A.E.

1) Central Clinical Hospital of the RAS, Moscow; 2) S.M. Kirov Military Medical Academy of the Ministry of Defense of Russia, St. Petersburg
Abstract. The aim of the study was to study the factors affecting the effectiveness of hypolypidemic therapy, on the basis of the analysis of doctors’ survey.
Material and methods. A questionnaire was developed, its questions characterized how practicing doctors adhere to clinical guidelines, how much of the arsenal of hypolypidemic drugs and their dosages is used, and also which factors having influence at the adherence of patients to the therapy, they consider to be actual.
Results. Only 41,90% of doctors prescribe statins to all patients with ischemic heart disease. Most of them have shown the correct target concentrations of low density lipoproteins cholesterol (HC LDL). Mostly often, doctors are using attorvastatin 10/20 mg (50,48%), rosuvastatin 10/15 mg (40,00%) and rosuvastatin 20 mg (53,33%). Only 64,8% (n=68) doctors operate at least 1 statin in a high dose. Almost all the respondents believe that the patient needs to be convinced of the admission of statins, while 87,62% prefer to explain why the use of these drugs is needed, and 26,67% refer to world practices and clinical recommendations. More than half of the doctors consider most patients to be committed to drug therapy and medical support. Approximately the same number of respondents believe that economic factors have significant influence on the commitment to hypolipidemic therapy. During the distribution in the order of importance of factors that can influence adherence to therapy, most doctors on the first place put an understanding of the importance of intake (35,24%) and the cost of drugs (30,48%). On second place, most specialists put the cost (18,10%) and the possibility of preferential getting (16,19%) of drugs.
Conclusion. Doctors are not sufficiently informed about the main features of hypolypidemic therapy, although they are oriented in the target values of the HC-LDL, depending on the cardiovascular risk, but they are exceedingly afraid to achieve these levels. According to the opinion of doctors, the main factors that increase the commitment to drug therapy is an understanding of the patient the importance of hypolypidemic drugs’ intake and their price.
Keywords: target concentrations of low density lipoproteins cholesterol, hypolypidemic therapy, commitment
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About the Autors

Denis E. Rozhkov, cardiologist-therapist, head of the admissions Department of Central Clinical Hospital of the RAS. Address: 117593, Moscow, 1a Lithuanian Boulevard. Tel.: +7 (916) 927-85-94. E-mail: rozhkov-17@yandex.ru
Vadim V. Tyrenko, MD, professor, head of the Department of faculty therapy named after S.P. Botkin, S.M. Kirov Military Medical Academy of the Ministry of Defense of Russia. Address: 194044, St. Petersburg, 6a Academika Lebedeva Str. Tel.: +7 (921) 996-23-14. E-mail: vadim_tyrenko@mail.ru
Aleksey E. Nikitin, MD, professor, chief physician of CENTRAL CLINICAL HOSPITAL of the RAS. Address: 117593, Moscow, 1a Lithuanian Boulevard. Tel.: +7 (499) 400-47-33. E-mail: glavvrach@ckbran.ru

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