Knowledge and Performance of Iranian Internists Regarding Dyslipidemia According to Lipid Guidelines and their Relationships with Personal and Occupational Characteristics
-
Faezeh Sadat Naji
,
Mehrzad Mirshekari
,
Soha Namazi
,
Hesam Aldin Varpaei
,
Alireza Esteghamati
,
Mahboobeh Hemmatabadi
,
Nooshin Shirzad
Abstract
Background: Lipid metabolism disorders are among the most common metabolic diseases that are increasing globally and are associated with chronic metabolic disturbances. The present study aimed to determine the knowledge and practice of internal medicine physicians concerning lipid disorders according to the AHA, AACE, ESC-EAS, and NCEP-ATP-III guidelines.
Methods: This descriptive-analytical cross-sectional study selected a convenience sample of 220 internal medicine specialists from January through September 2021 in Tehran and some other Iranian cities. A 25-item researcher-designed questionnaire was used. Suggested scenarios were designed by emphasizing the points of difference in the guidelines. Content validity was approved by 10 tenured faculty members, and reliability was tested with the test-retest method.
Results: Women comprised 60% of the population. In addition, 3.2% (n=7) of the physicians had poor knowledge, 95.0% (n=209) had moderate knowledge, and 1.8% (n=4) had good knowledge of lipid disorders based on international guidelines. Moreover, performance regarding lipid disorders was poor in 25 (11.4%), moderate in 164 (74.5%), and good in 31 (14.1%) physicians. The knowledge score decreased, whereas the practice score increased with age. The knowledge score of female physicians was significantly higher than that of their male counterparts. The knowledge score was negatively correlated with the physician’s years of experience.
Conclusion: The knowledge and performance of internists regarding dyslipidemia were rated moderate according to the AHA, AACE, ESC-EAS and NCEP-ATP III guidelines.
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12. Kones R. Primary prevention of coronary heart disease: integration of new data, evolving views, revised goals, and role of rosuvastatin in management. A comprehensive survey. Drug Des Devel Ther 2011;5:325-380.
13. Said AH, Chia YC. Awareness, knowledge and practice of dyslipidaemia management among postgraduate primary care trainees in Malaysia: a cross-sectional study. BMJ Open 2017;7:e013573.
14. Alhajji S, Mojiminiyi S. Adherence to Current Lipid Guidelines by Physicians in Kuwait. Med Princ Pract 2020;29:436-443.
15. Zaitoun MF, Iflaifel MH, Almulhim LA, Al-Ghamdi MA, Ibrahim YA. Awareness of Physicians and Clinical Pharmacists About ACC/AHA Guidelines for Dyslipidemia Management: A Cross-Sectional Study. J Pharm Bioallied Sci 2019;11:181-186.
16. Bucheit JD, Helsing H, Nadpara P, Virani SS, Dixon DL. Clinical pharmacist understanding of the 2013 American College of Cardiology/American Heart Association cholesterol guideline. J Clin Lipidol 2018;12:367-374.e3.
17. Alshamiri M, Ghanaim MMA, Barter P, Chang KC, Li JJ, Matawaran BJ, Santoso A, Shaheen S, Suastika K, Thongtang N, Yusof AK. Expert opinion on the applicability of dyslipidemia guidelines in Asia and the Middle East. Int J Gen Med 2018;11:313-322.
18. Aburuz S, Al-Bekairy A, Alqahtani AA, Harbi K, Al Nuhait M, Khoja A, Sadeq A, Al Rashed M. Comparison of the application of treatment Panel III and American College of Cardiology/American heart Association guidelines for blood cholesterol treatment in Saudi Arabia. J Saudi Heart Assoc 2018;30:349-355.
19. Kara E, Tecen Yucel K, Bayraktar-Ekincioglu A, Demirkan K, Tokgozoglu L, Unal S. Evaluation of internal medicine physicians' attitudes toward the treatment of dyslipidemia. Postgrad Med 2020;132:538-543.
20. Mahtta D, Rodriguez F, Jneid H, Levine GN, Virani SS. Improving adherence to cardiovascular guidelines: realistic transition from paper to patient. Expert Rev Cardiovasc Ther 2020;18:41-51.
21. Reiner Z, Sonicki Z, Tedeschi-Reiner E. Physicians' perception, knowledge and awareness of cardiovascular risk factors and adherence to prevention guidelines: the PERCRO-DOC survey. Atherosclerosis 2010;213:598-603.
22. Vashitz G, Meyer J, Parmet Y, Henkin Y, Peleg R, Gilutz H. Physician adherence to the dyslipidemia guidelines is as challenging an issue as patient adherence. Fam Pract 2011;28:524-531.
23. Abbasi K, Karimi A, Abbasi SH, Ahmadi SH, Davoodi S, Babamahmoodi A, Movahedi N, Salehiomran A, Shirzad M, Bina P. Knowledge management in cardiac surgery: the second tehran heart center adult cardiac surgery database report. J Tehran Heart Cent 2012;7:111-116.
24. Guan F, Xie J, Wang GL, Wang JH, Wang JS, Yu JM, Hu DY. Community-wide survey of physicians' knowledge of cholesterol management. Chin Med J (Engl) 2010;123:884-889.
25. Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, Rubin HR. Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999;282:1458-1465.
26. Mirshekari M, Shirzad N, Hemmatabadi M, Namazi S. The approach of Iranian clinical pharmacists in the treatment of dyslipidemia based on international guidelines. J Cardiovasc Thorac Res 2023;15:30-36.
2. Tabatabaei-Malazy O, Qorbani M, Samavat T, Sharifi F, Larijani B, Fakhrzadeh H. Prevalence of dyslipidemia in iran: a systematic review and meta-analysis study. Int J Prev Med 2014;5:373-393.
3. Walsh JM, Pignone M. Drug treatment of hyperlipidemia in women. JAMA 2004;291:2243-2252.
4. Krepel Volsky S, Shalitin S, Fridman E, Yackobovitch-Gavan M, Lazar L, Bello R, Oron T, Tenenbaum A, de Vries L, Lebenthal Y. Dyslipidemia and cardiovascular disease risk factors in patients with type 1 diabetes: A single-center experience. World J Diabetes 2021;12:56-68.
5. Ni WQ, Liu XL, Zhuo ZP, Yuan XL, Song JP, Chi HS, Xu J. Serum lipids and associated factors of dyslipidemia in the adult population in Shenzhen. Lipids Health Dis 2015;14:71.
6. Bayram F, Kocer D, Gundogan K, Kaya A, Demir O, Coskun R, Sabuncu T, Karaman A, Cesur M, Rizzo M, Toth PP, Gedik V. Prevalence of dyslipidemia and associated risk factors in Turkish adults. J Clin Lipidol 2014;8:206-216.
7. Rhee EJ, Kim HC, Kim JH, Lee EY, Kim BJ, Kim EM, Song Y, Lim JH, Kim HJ, Choi S, Moon MK, Na JO, Park KY, Oh MS, Han SY, Noh J, Yi KH, Lee SH, Hong SC, Jeong IK; Committee of Clinical Practice Guideline of Korean Society of Lipid and Atherosclerosis. 2018 Guidelines for the management of dyslipidemia in Korea. Korean J Intern Med 2019;34:1171.
8. Hendrani AD, Adesiyun T, Quispe R, Jones SR, Stone NJ, Blumenthal RS, Martin SS. Dyslipidemia management in primary prevention of cardiovascular disease: Current guidelines and strategies. World J Cardiol 2016;8:201-210.
9. Turgeon RD, Anderson TJ, Grégoire J, Pearson GJ. Updated guidelines for the management of dyslipidemia and prevention of cardiovascular disease by pharmacists. Can Pharm J (Ott) 2015;148:21-28.
10. Giner-Galvañ V, Esteban-Giner MJ, Pallarés-Carratalá V. Overview of guidelines for the management of dyslipidemia: EU perspectives. Vasc Health Risk Manag 2016;12:357-369.
11. Al Sayed N, Al Waili K, Alawadi F, Al-Ghamdi S, Al Mahmeed W, Al-Nouri F, Al Rukhaimi M, Al-Rasadi K, Awan Z, Farghaly M, Hassanein M, Sabbour H, Zubaid M, Barter P. Consensus clinical recommendations for the management of plasma lipid disorders in the Middle East. Int J Cardiol 2016;225:268-283.
12. Kones R. Primary prevention of coronary heart disease: integration of new data, evolving views, revised goals, and role of rosuvastatin in management. A comprehensive survey. Drug Des Devel Ther 2011;5:325-380.
13. Said AH, Chia YC. Awareness, knowledge and practice of dyslipidaemia management among postgraduate primary care trainees in Malaysia: a cross-sectional study. BMJ Open 2017;7:e013573.
14. Alhajji S, Mojiminiyi S. Adherence to Current Lipid Guidelines by Physicians in Kuwait. Med Princ Pract 2020;29:436-443.
15. Zaitoun MF, Iflaifel MH, Almulhim LA, Al-Ghamdi MA, Ibrahim YA. Awareness of Physicians and Clinical Pharmacists About ACC/AHA Guidelines for Dyslipidemia Management: A Cross-Sectional Study. J Pharm Bioallied Sci 2019;11:181-186.
16. Bucheit JD, Helsing H, Nadpara P, Virani SS, Dixon DL. Clinical pharmacist understanding of the 2013 American College of Cardiology/American Heart Association cholesterol guideline. J Clin Lipidol 2018;12:367-374.e3.
17. Alshamiri M, Ghanaim MMA, Barter P, Chang KC, Li JJ, Matawaran BJ, Santoso A, Shaheen S, Suastika K, Thongtang N, Yusof AK. Expert opinion on the applicability of dyslipidemia guidelines in Asia and the Middle East. Int J Gen Med 2018;11:313-322.
18. Aburuz S, Al-Bekairy A, Alqahtani AA, Harbi K, Al Nuhait M, Khoja A, Sadeq A, Al Rashed M. Comparison of the application of treatment Panel III and American College of Cardiology/American heart Association guidelines for blood cholesterol treatment in Saudi Arabia. J Saudi Heart Assoc 2018;30:349-355.
19. Kara E, Tecen Yucel K, Bayraktar-Ekincioglu A, Demirkan K, Tokgozoglu L, Unal S. Evaluation of internal medicine physicians' attitudes toward the treatment of dyslipidemia. Postgrad Med 2020;132:538-543.
20. Mahtta D, Rodriguez F, Jneid H, Levine GN, Virani SS. Improving adherence to cardiovascular guidelines: realistic transition from paper to patient. Expert Rev Cardiovasc Ther 2020;18:41-51.
21. Reiner Z, Sonicki Z, Tedeschi-Reiner E. Physicians' perception, knowledge and awareness of cardiovascular risk factors and adherence to prevention guidelines: the PERCRO-DOC survey. Atherosclerosis 2010;213:598-603.
22. Vashitz G, Meyer J, Parmet Y, Henkin Y, Peleg R, Gilutz H. Physician adherence to the dyslipidemia guidelines is as challenging an issue as patient adherence. Fam Pract 2011;28:524-531.
23. Abbasi K, Karimi A, Abbasi SH, Ahmadi SH, Davoodi S, Babamahmoodi A, Movahedi N, Salehiomran A, Shirzad M, Bina P. Knowledge management in cardiac surgery: the second tehran heart center adult cardiac surgery database report. J Tehran Heart Cent 2012;7:111-116.
24. Guan F, Xie J, Wang GL, Wang JH, Wang JS, Yu JM, Hu DY. Community-wide survey of physicians' knowledge of cholesterol management. Chin Med J (Engl) 2010;123:884-889.
25. Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, Rubin HR. Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999;282:1458-1465.
26. Mirshekari M, Shirzad N, Hemmatabadi M, Namazi S. The approach of Iranian clinical pharmacists in the treatment of dyslipidemia based on international guidelines. J Cardiovasc Thorac Res 2023;15:30-36.
| Files | ||
| Issue | Vol 19 No 1 (2024): J Teh Univ Heart Ctr | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jthc.v19i1.15532 | |
| Keywords | ||
| Internal medicine Lipid metabolism disorders Knowledge American heart association | ||
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How to Cite
1.
Naji FS, Mirshekari M, Namazi S, Varpaei HA, Esteghamati A, Hemmatabadi M, Shirzad N. Knowledge and Performance of Iranian Internists Regarding Dyslipidemia According to Lipid Guidelines and their Relationships with Personal and Occupational Characteristics. J Tehran Heart Cent. 2024;19(1):14-24.
