[The quality of the drug treatment in hyperlipemia patients from 4 health areas. The VICAF Group].

OBJECTIVE

To calculate how suitable the lipid-lowering treatment prescribed for pensioners in primary care clinics in four health areas is.

DESIGN

Cross-sectional descriptive study of quality of pharmacological treatment.

SETTING

Four primary care health districts, INSALUD, Madrid.

PARTICIPANTS

1125 patients registered with 49 doctors, chosen at random on the basis of three strata defined by the value of the lipid-lowering drug indicator of prescription. For a year, each doctor filled in a protocol of variables for each pensioner to whom he/she prescribed a lipid-lowering drug.

MEASUREMENTS AND MAIN RESULTS

An automated algorithm was designed to evaluate the suitability of the drugs treatment for each patient, according to scientific criteria including: cholesterol levels, LDL, age, and risk factors. Quality of prescription was finally measured for 1009 patients. The indication of the treatment was due to primary prevention in 65% of cases. 32% of patients were correctly treated. If LDL compliance was not demanded, the suitability figure rose to 77%. Drug treatment was more suitable when the doctor him/herself administered it (as against another doctor or a specialist; p = 0.001) or when the patient was on the list of the prescribing doctor (p < 0.0001). Proper indication was lower in patients over 74 (p < 0.0001).

CONCLUSIONS

The quality of lipid-lowering drug prescription for pensioners in primary care clinics in four health districts, as a function of the criteria defined above, could be improved. LDL is the factor which most affects the procedure.