Is the physician's behavior in dyslipidemia diagnosis in accordance with guidelines? Cross-sectional ESCARVAL study.

Clinical inertia has been defined as mistakes by the physician in starting or intensifying treatment when indicated. Inertia, therefore, can affect other stages in the healthcare process, like diagnosis. The diagnosis of dyslipidemia requires ≥2 high lipid values, but inappropriate behavior in the diagnosis of dyslipidemia has only previously been analyzed using just total cholesterol (TC).To determine clinical inertia in the dyslipidemia diagnosis using both TC and high-density lipoprotein cholesterol (HDL-c) and its associated factors.Cross-sectional.All health center visits in the second half of 2010 in the Valencian Community (Spain).11,386 nondyslipidemic individuals aged ≥20 years with ≥2 lipid determinations.Gender, atrial fibrillation, hypertension, diabetes, cardiovascular disease, age, and ESCARVAL training course. Lipid groups: normal (TC<5.17 mmol/L and normal HDL-c [≥1.03 mmol/L in men and ≥1.29 mmol/L in women], TC inertia (TC≥5.17 mmol/L and normal HDL-c), HDL-c inertia (TC<5.17 mmol/L and low HDL-c), and combined inertia (TC≥5.17 mmol/L and low HDL-c).TC inertia: 38.0% (95% CI: 37.2-38.9%); HDL-c inertia: 17.7% (95% CI: 17.0-18.4%); and combined inertia: 9.6% (95% CI: 9.1-10.2%). The profile associated with TC inertia was: female, no cardiovascular risk factors, no cardiovascular disease, middle or advanced age; for HDL-c inertia: female, cardiovascular risk factors and cardiovascular disease; and for combined inertia: female, hypertension and middle age.Cross-sectional study, under-reporting, no analysis of some cardiovascular risk factors or other lipid parameters.A more proactive attitude should be adopted, focusing on the full diagnosis of dyslipidemia in clinical practice. Special emphasis should be placed on patients with low HDL-c levels and an increased cardiovascular risk

Descriptive analysis of inertia groups for dyslipidemia at primary health care centers in a Spanish region.

<p>Abbreviations: n(%), absolute frequency(relative frequency); TC, total cholesterol; HDL-c, high density lipoprotein cholesterol.</p

Analysis of factors associated with inertia groups for dyslipidemia at primary health care centers in a Spanish region.

<p>Abbreviations: TC, total cholesterol; HDL-c, high density lipoprotein cholesterol; Adj. OR, Adjusted Odds Ratio; CI, Confidence Interval.</p><p>Goodness-of-fit of the inertia models: TC: <i>X²</i> = 552.7, p<0.001; HDL-c: <i>X</i>² = 182.9, p<0.001; Combined: <i>X</i>² = 205.7, p<0.001.</p><p>OR adjusted for gender, atrial fibrillation, hypertension, diabetes mellitus, cardiovascular disease, age groups and the on-line course.</p><p>^*: Reference.</p

Main characteristics of the studies that evaluate clinical inertia in the diagnosis of dyslipidemia.

<p>Abbreviations: TC, total cholesterol; DM, diabetes mellitus; CVD, cardiovascular disease. *: This value was obtained through a weighted average. ^†: The sample size is not given in the original article. We therefore obtained it from linear programming mathematical calculations based on the Simplex method.</p

Nondyslipidemic patients at primary healthcare centers in a Spanish region.

<p>CI, confidence interval; TC, total cholesterol; HDL-c; high-density lipoprotein cholesterol.</p