Prevention of coronary heart disease in primary medical care in Poland: results from the LIPIDOGRAM study

Eur J Cardiovasc Prev Rehabil. 2011 Apr;18(2):287-96. doi: 10.1177/1741826710389366. Epub 2011 Jan 31.

Abstract

Aims: To determine: (1) achievement of cholesterol therapy goals in patients receiving lipid-lowering drugs in Polish primary care between the years 2004 and 2006; (2) the characteristics of patients that are associated with attainment of these goals.

Design: Cross-sectional study in randomly selected Polish primary care practices.

Method: 5248 patients aged over 30 years in 2004 and 5386 patients in 2006, who were taking cholesterol-lowering treatment took part in the study. Physicians recorded demographic and medical history data using a standardized questionnaire, including weight and height, and collected blood samples of patients to determine their cholesterol level.

Results: 18.5% of patients attained their optimal goals of therapy (total cholesterol, TC; low-density lipoprotein cholesterol, LDL-C) in 2004 compared to 25.2% in 2006 (p < 0.001). In both 2004 and 2006, more patients achieved their target levels for LDL-C than for TC and statins were the most commonly used medication (85% and 91%, respectively). Male sex, smoking, and higher education were the strongest correlates of the therapeutic outcome. The odds ratio of achieving cholesterol therapy goals in men, non-smokers, and university graduates was estimated at 1.51, 0.70, 1.38 in 2004 and 1.50, 0.73, 1.34 in 2006, respectively.

Conclusion: There was a measurable improvement in the effectiveness of hypercholesterolaemia treatment between 2004 and 2006 but the majority of patients remain inadequately treated, with goals not being achieved. There is a need to raise the standard of lipid-lowering management in Poland.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anticholesteremic Agents / therapeutic use*
  • Biomarkers / blood
  • Chi-Square Distribution
  • Cholesterol / blood
  • Cholesterol, LDL / blood
  • Coronary Disease / blood
  • Coronary Disease / etiology
  • Coronary Disease / prevention & control*
  • Cross-Sectional Studies
  • Drug Utilization
  • Female
  • Guideline Adherence
  • Health Care Surveys
  • Humans
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / complications
  • Hypercholesterolemia / drug therapy*
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Poland
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'* / statistics & numerical data
  • Preventive Health Services* / statistics & numerical data
  • Primary Health Care* / statistics & numerical data
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome

Substances

  • Anticholesteremic Agents
  • Biomarkers
  • Cholesterol, LDL
  • Cholesterol