Korean Circ J.  2006 Aug;36(8):593-599. 10.4070/kcj.2006.36.8.593.

Treatment Gap in the Management of Hypercholesterolemia in Korea: Return on Expenditure Achieved for LIpid TherapY (REALITY)

• Kim SH
• Park JS
• Zo JH
• Kim MA
• Kim HS

• KMID: 1859068
• DOI: http://doi.org/10.4070/kcj.2006.36.8.593

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.

Keyword

Hypercholesterolemia; Guideline; Coronary disease

MeSH Terms

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
Cholesterol
Cholesterol, LDL