Physicians’ misperceived cardiovascular risk and therapeutic inertia as determinants of low LDL-cholesterol targets achievement in diabetes

• DOI: 10.1186/s12933-022-01495-8
• Publication Date: 2022-04-26T19:09:28Z
• Authors: Mario Luca Morieri; Olga Lamacchia; Enzo Manzato; Andrea Giaccari; Angelo Avogaro; ; Lucio Amoresano; Stefania Angotti; Laura Bartone; Francesco Caraffa; Antonello Carboni; Stefano Carro; Silvestre Cervone; Alessandra Clerico; Ida Console; Danilo Mario Conti; Sergio D’Addato; Alessandra de Bellis; Francesco de Meo; Alberto di Carlo; Graziano di Cianni; Giuseppe di Giovanni; Sergio di Lembo; Fabrizio Diacono; Mara Dolcino; Giovanni Elia; Paolo Elli; Cristina Fatone; Angelica Galli; Giovanni Galluzzo; Adriana Garzaniti; Renata Ghelardi; Anna Giacchini; Loretta Giunta; Francesco Golia; Franco Gregorio; Dario Ierna; Antonio Lampitella; Antonio Luciano; Ada Maffettone; Raffaele Mancini; Ida Mangone; Linneo Enzo Manto...; Alberto Marangoni; Giuseppe Marelli; Narciso Marin; Gennaro Marino; Eugenio Mastromatteo; Gaetano Mazziotti; Elisa Me; Giuseppe Memoli; Laura Silvia Mari...; Simona Moffa; Manuela Moise’; Fabrizio Monaco; Sara Nazzarena Mo...; Francesca Pellicano; Ettore Petraroli; Deamaria Piersanti; Antonino Pipitone; Susanna Puglisi; Maura Rinaldi; Mario Rizzo; Maura Rosco; Giampaolo Scollo; Natalino Simioni; Mariarosaria Squa...; Giacomo Sturniolo; Anna Tedeschi; Biagio Tizio; Diletta Ugolotti; Livio Valente; Carmela Vinci; Luca Zenoni; Maria Grazia Zenti
• Keywords: Medical record

Abstract Background Greater efforts are needed to overcome the worldwide reported low achievement of LDL-c targets. This survey aimed dissect whether and how physician-based evaluation patients with diabetes is associated Methods cross-sectional self-reported interviewed physicians working in 67 outpatient services Italy, collecting records on 2844 diabetes. Each physician a median 47 (IQR 42–49) and, for each them, specified its perceived cardiovascular risk, targets, suggested refinement lipid-lowering-treatment (LLT). These evaluations were then compared recommendations from EAS/EASD guidelines. Results Collected mostly type 2 (94%), at very-high (72%) or high-cardiovascular risk (27%). Physician-based assessments as guidelines recommendation, misclassified 34.7% records. The misperceived assessment was significantly higher among females those primary prevention 67% lower odds achieving guidelines-recommended targets (OR 0.33, p < 0.0001). Peripheral artery disease, target organ damage LLT-initiated by primary-care-physicians all factors therapeutic-inertia (i.e., than expected probability receiving high-intensity LLT). Physician-suggested LLT inadequate 24% overall increased 38% subjects risk. Conclusions highlights need improve physicians’ therapeutic inertia successfully implement into everyday clinical practice.