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Evaluation of infectious diseases physicians' attitudes to dyslipidemia management in PLWH
Fatma Nisa Balli Turhan1,2, Emre Kara2, Oğuz Abdullah Uyaroğlu3
1Department of Clinical Pharmacy, Gazi University Faculty of Pharmacy, Ankara, Türkiye.
Insights
Many infectious diseases physicians don't follow dyslipidemia guidelines for people with HIV (PLWH). Physician workload, time constraints, and patient skepticism hinder optimal atherosclerotic cardiovascular disease (ASCVD) risk management in PLWH.
Area of Science:
- Infectious Diseases
- Cardiology
- Public Health
Background:
- Dyslipidemia is a significant risk factor for atherosclerotic cardiovascular disease (ASCVD).
- People living with HIV (PLWH) have double the ASCVD prevalence compared to the general population.
- Effective dyslipidemia management in PLWH is crucial for preventing ASCVD.
Purpose of the Study:
- To assess the attitudes of infectious diseases (ID) physicians regarding dyslipidemia management in PLWH.
- To identify barriers and facilitators influencing the adoption of clinical guidelines for dyslipidemia in this population.
Main Methods:
- An observational, cross-sectional study utilizing an online survey.
- Survey distributed to ID physicians via local ID societies from November 2023 to February 2024.
- Data collected on physician demographics, guideline adherence, and attitudes towards dyslipidemia treatment in PLWH.
Main Results:
- 59.9% of respondents were ID specialists, 40.1% were ID residents.
- 41% did not follow dyslipidemia guidelines, and 26% did not use cardiovascular risk calculators.
- Physician skepticism (72%) and patient skepticism (73%) were significant concerns, alongside workload and time constraints (68.6%).
Conclusions:
- A notable proportion of Turkish ID physicians exhibit suboptimal adherence to dyslipidemia and ASCVD risk assessment guidelines.
- Factors such as workload, time, patient skepticism, and knowledge gaps influence statin prescribing practices.
- Enhanced training for ID physicians on primary ASCVD prevention and dyslipidemia management in PLWH is essential.
Objectives:
Dyslipidemia is a well-established risk factor for atherosclerotic cardiovascular disease (ASCVD). ASCVD prevalence among people living with HIV (PLWH) is twice that of the general population. This study aimed to evaluate the infectious diseases (ID) physicians' attitudes on dyslipidemia management in PLWH.
Methods:
This observational, cross-sectional study was conducted as online survey among ID physicians between November 2023 and February 2024. An e-mail with the survey link, title and purpose of the study was sent to physicians through the local ID societies. The survey included questions about physicians' demographic characteristics and their attitudes toward treating dyslipidemia in PLWH.
Results:
A total of 242 physicians responded to the survey, of whom 59.9% (n = 145) were ID specialists and 40.1% (n = 97) were ID residents. Forty-one percent (n = 100) of physicians reported that they did not follow a guideline, and 26% of physicians reported that they did not use a cardiovascular risk calculator in their clinical practice. Specialists (69%) were more likely than residents (43.3%) to follow clinical guidelines for dyslipidemia management (p < 0.001). Seventy-two percent (n = 174) of physicians doubted the need to treat dyslipidemia, and 73% (n = 177) of physicians were affected by the patient skepticism. Workload and lack of time were identified by 68.6% of physicians as barriers to implementing dyslipidemia guideline recommendations.
Conclusion:
A considerable number of Turkish ID physicians did not prefer using clinical guidelines for dyslipidemia and ASCVD risk calculators. Statin prescribing of physicians was influenced by workload, lack of time, patient skepticism, and lack of knowledge. Training ID physicians in primary prevention of ASCVD and management of dyslipidemia in PLWH is paramount.
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