Physicians’ Attitudes of Lipid Management in Tertiary Hospitals in China---A Cross-Sectional Study

Abstract

Background: Hyperlipidemia is increasingly prevalent in China. Gaps are found between 2016 Chinese guideline for lipid management and other international guidelines. This study aims to identify attitudes and reported practice patterns for hyperlipidemia among Chinese physicians in tertiary hospitals. Methods: We collected data for 309 physicians on their adoption of guidelines, their attitudes of statin therapy and reported statin prescription patterns in four hypothetical patient scenarios (low risk/high LDL, high risk/high LDL, low risk/low LDL, and high risk/low LDL patients). Results: Overall, 63.75% of physicians adopted 2016 Chinese guideline. Most highly agreed with statins’ effectiveness, but 57.94% concerned about the safety of high-intensity statins in the Chinese population. Physicians reported various LDL-C value for treatment target. In hypothetical scenarios, the prescription rate was highest for the high risk/high LDL patient (90.03%). Those who believed statins could prevent stroke and heart attack were more likely to prescribe statins (OR=5.67,p=0.002). The prescription rate was 81.42% for the patient at risk/low LDL. Those who believed statins could prolong life were more likely to prescribe (OR=2.51, P=0.009). Only 7.78% 2016 Chinese guideline adopters prescribed statins as guideline recommended on all four hypothetical patients. Most physicians (56.73%-73.91%) preferred moderate-intensity statins. Those who considered high-intensity statins shouldn’t be routinely used in Chinese were less likely to prescribe high-intensity statins(OR=0.33, p=0.004). Conclusions: Physicians concerned about statins’ safety; We didn’t find a specific practice pattern among physicians and guideline adopters’ reported practices were not always concordant with the recommendations; Future studies are expected to focus on high-intensity statins and LDL-C target for treatment and training on guideline use is necessary;