Treatment Gap in the Management of Hypercholesterolemia in Korea: Return on Expenditure Achieved for LIpid TherapY (REALITY).
10.4070/kcj.2006.36.8.593
- Author:
Sang Hyun KIM
1
;
Jin Shik PARK
;
Joo Hee ZO
;
Myung A KIM
;
Hyo Soo KIM
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. hyosoo@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Hypercholesterolemia;
Guideline;
Coronary disease
- MeSH:
Cardiovascular Diseases;
Cholesterol;
Cholesterol, LDL;
Coronary Disease;
Health Expenditures*;
Hospitals, General;
Humans;
Hydroxymethylglutaryl-CoA Reductase Inhibitors;
Hypercholesterolemia*;
Korea*;
Logistic Models;
Medical Records;
Negotiating;
Research Personnel;
Retrospective Studies
- From:Korean Circulation Journal
2006;36(8):593-599
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Several studies have showed a large 'treatment gap' between clinical practice and the guidelines for treating hypercholesterolemia. There is little information on the real practice of managing patients with hypercholesterolemia in Korea. This study was done to investigate the "treatment gap" in the management of Korean hypercholesterolemic patients. SUBJECTS AND METHODS: 500 Hypercholesterolemic patients, who did not receive any lipid-lowering mediation during the prior six months to the index date and who were treated for more than one year thereafter, were included in the study. 100 investigators of general hospitals retrospectively reviewed the medical records of 500 hypercholesterolemic patients. The proportion of patients who reached their cholesterol goal was determined. Logistic regression was used to assess the patient characteristics associated with goal attainment. RESULTS: Of the total 500 patients, 369 patients (73.8%) had coronary heart disease (CHD) or CHD risk-equivalent disease. 86 patients (17.2%) were in the moderate risk group and 45 (9.0%) were in the low risk group. 45% of the CHD/CHD risk equivalent patients showed a baseline LDL cholesterol level of more than 160 mg/dL. The overall trend for the initial choice of the drug level for statin treatment showed a similar pattern among all patients, and this was not influenced by the presence of CHD or the serum lipid level. 77% of patients stayed on the same drug level and 41% of all patients (37% of CHD patients, 52% of non-CHD patients) attained their LDL cholesterol goal during the study period. CONCLUSION: The majority of hypercholesterolemic patients were treated without achieving their goal. More effective treatment of hypercholesterolemia is needed for the prevention of cardiovascular disease.
