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首页> 外文期刊>BMC Family Practice >Trends in total cholesterol screening and in prescribing lipid-lowering drugs in general practice in the period 1994–2003
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Trends in total cholesterol screening and in prescribing lipid-lowering drugs in general practice in the period 1994–2003

机译：1994-2003年期间一般实践中总胆固醇筛查和降脂药处方的趋势

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Background General Practitioners (GPs) play a central role in controlling an important risk factor for cardiovascular diseases, i.e. cholesterol levels in serum. In the past few decades different studies have been published on the effect of treating hyperlipidemia with statins. Guidelines for treatment have been adopted. We investigated the consequences on the practice of GPs screening cholesterol levels and on the timing of starting statin prescription. Methods For this descriptive study, data from the Intego database were used, composed with data from the electronic medical records (EMR) of 47 general practices in Flanders. GPs had not received special instructions for testing specific patients. For each patient the mean cholesterol level per year was calculated. A patient belonged to the group with lipid-lowering drugs if there was at least one prescription of the drug in a year in his EMR. Mixed model linear regression models were used to quantify the effect of covariates on total cholesterol values. Results In the period 1994–2003 total cholesterol was tested in 47,254 out of 139,148 different patients. Twelve percent of those tested took lipid-lowering medication. The proportion of patients with at least one cholesterol test a year, increased over a period of ten years in all age groups, but primarily for those over the age of 65. The mean cholesterol level decreased in the treated as well as in the non-treated group. Of the patients with a cardiovascular antecedent who were on lipid-lowering drugs in 2003, 56% had a cholesterol level ≤ 199 mg/dl, 31% between 200–239 and 13% over 240 mg/dl. Conclusion The indications for testing and treating cholesterol levels broadened considerably in the period examined. In 2003 cholesterol was tested in many more patients and patients were already treated at lower cholesterol values than in previous years. Comparisons of cholesterol levels over different years should therefore be interpreted with caution as they are a reflection of changes in medical care, and not necessarily of efficacy of treatment.
机译：背景技术全科医生（GP）在控制心血管疾病的重要危险因素（即血清中的胆固醇水平）方面起着核心作用。在过去的几十年中，已发表了关于他汀类药物治疗高脂血症疗效的不同研究。通过了治疗指南。我们调查了全科医生筛选胆固醇水平的实践以及开始他汀类药物处方时机的后果。方法为了进行描述性研究，使用了Intego数据库中的数据，以及来自法兰德斯47个常规医疗机构的电子病历（EMR）的数据。全科医生没有收到有关测试特定患者的特殊说明。对于每位患者，计算每年的平均胆固醇水平。如果在他的EMR中一年中至少有一张处方药，则该患者属于降脂药物组。混合模型线性回归模型用于量化协变量对总胆固醇值的影响。结果在1994年至2003年期间，对139,148名不同患者中的47,254名总胆固醇进行了测试。接受测试的人中有12％服用了降脂药。在所有年龄段中，每年至少进行一次胆固醇测试的患者比例在十年内有所增加，但主要针对65岁以上的人群。在接受治疗的患者和未接受治疗的非胆固醇患者中，平均胆固醇水平均下降治疗组。在2003年使用降脂药物的心血管先例患者中，有56％的胆固醇水平≤199 mg / dl，在200-239之间的胆固醇水平为31％，在240 mg / dl以上的胆固醇为13％。结论在所研究的时期内，检测和治疗胆固醇水平的适应症大大扩展。 2003年，对更多患者进行了胆固醇测试，并且已经接受了比往年更低的胆固醇治疗。因此，应谨慎地解释不同年份胆固醇水平的比较，因为它们反映了医疗保健的变化，并不一定反映治疗效果。

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