Real vs perceived LDL cholesterol control in clinical practice in Spain: Which factors are related to real control?

Abstract Background/Introduction According to ESC Guidelines, low-density lipoprotein cholesterol (LDLc) reduction is essential for the control of dyslipidaemia. Frequently, the physicians’ perception of LDLc control in patients (pts) is higher than the actual control, potentially leading to a suboptimal management of these pts. Purpose To understand the impact of physicians’ perception on LDLc control using a multivariate analysis and identify other potential predictive factors in the management of pts with dyslipidaemia in Spain. Methods Cross-sectional and multicentre study that included 435 healthcare professionals (34% cardiologists, 28% General Practitioners [GPs], 24% internists, and 14% endocrinologists) from 145 healthcare areas in Spain. Qualitative and quantitative information related to the management of pts with dyslipidaemia in clinical practice was collected. Additionally, aggregated anonymized data of the last 10 pts with dyslipidaemia attended by each physician were collected. With these data, a multivariate analysis was performed to estimate the impact of different variables on real LDLc control, including: age, gender and speciality of the physician, category of prevention, presence of comorbidities, lipid-lowing therapy (LLT) used, and whether the physician accurately perceived the real LDLc control. Results 4,010 pts (8%, 13%, 16% and 61% with low, moderate, high, and very high CV risk) were included. Physicians’ perception was that 62% of the pts achieved LDLc goals, but in actual clinical practice only 31% of pts did (p