DESIGN: Cross sectional study.
SETTING: Postgraduate primary care trainees in Malaysia.
PARTICIPANTS: 759 postgraduate primary care trainees were approached through email or hard copy, of whom 466 responded.
METHOD: A self-administered questionnaire was used to assess their awareness, knowledge and practice of dyslipidaemia management. The total cumulative score derived from the knowledge section was categorised into good or poor knowledge based on the median score, where a score of less than the median score was categorised as poor and a score equal to or more than the median score was categorised as good. We further examined the association between knowledge score and sociodemographic data. Associations were considered significant when p<0.05.
RESULTS: The response rate achieved was 61.4%. The majority (98.1%) were aware of the national lipid guideline, and 95.6% reported that they used the lipid guideline in their practice. The median knowledge score was 7 out of 10; 70.2% of respondents scored 7 or more which was considered as good knowledge. Despite the majority (95.6%) reporting use of guidelines, there was wide variation in their clinical practice whereby some did not practise based on the guidelines. There was a positive significant association between awareness and the use of the guideline with knowledge score (p<0.001). However there was no significant association between knowledge score and sociodemographic data (p>0.05).
CONCLUSIONS: The level of awareness and use of the lipid guideline among postgraduate primary care trainees was good. However, there were still gaps in their knowledge and practice which are not in accordance with standard guidelines.
METHODS: The Dyslipidemia International Study (DYSIS) II was a multinational observational study of patients with stable CHD and hospitalised patients with an acute coronary syndrome (ACS). A full lipid profile and use of LLT were documented at baseline, and for the ACS cohort, at four months post-hospitalisation.
RESULTS: 325 patients were recruited from four sites in Singapore; 199 had stable CHD and 126 were hospitalised with an ACS. At baseline, 96.5% of the CHD cohort and 66.4% of the ACS cohort were being treated with LLT. In both cohorts, low-density lipoprotein cholesterol (LDL-C) levels were lower for the treated than the non-treated patients; accordingly, a higher proportion of patients met the LDL-C goal of < 70 mg/dL (CHD: 28.1% vs. 0%, p = 0.10; ACS: 20.2% vs. 0%, p < 0.01). By the four-month follow-up, a higher proportion of the ACS patients that were originally not treated with LLT had met the LDL-C goal (from 0% to 54.5%), correlating with the increased use of medication. However, there was negligible improvement in the patients who were treated prior to the ACS.
CONCLUSION: Dyslipidaemia is a significant concern in Singapore, with few patients with stable or acute CHD meeting the recommended European Society of Cardiology/European Atherosclerosis Society goal. LLT was widely used but not optimised, indicating considerable scope for improved management of these very-high-risk patients.