Drug use evaluation of antidyslipidemic agents at a community hospital in Japan

Objectives: In recent years, the therapeutic implications of dyslipidemias have been clarified in large-scale epidemiologic surveys, and the validity of pharmacotherapy has been established. We investigated the practical realities of pharmacotherapy for dyslipidemias at a community hospital in Japan. Methods: Medical chart surveys were performed retrospectively on 451 dyslipidemic outpatients who visited a community hospital in Japan in July 1997. We collected clinical data from medical charts regarding selected drugs for dyslipidemias, serum lipid levels before drug treatment and after one year of treatment, and risk factors for coronary heart disease (CHD). Results: Regardless of dyslipidemia phenotype, approximately 80% of patients were administered statins. The possibility was raised that physicians recorded risk factors in medical charts incompletely, particularly with regard to family CHD history, smoking, and obesity. Based on Japanese and us guidelines for dyslipidemias, low-density lipoprotein (LDL) cholesterol levels fully satisfied the requirements for initiating pharmacotherapy in the present study. However, the higher the risk of CHD, the lower the percentage of subjects who met the treatment goals defined by both guidelines. Only 23% of patients at high risk for CHD controlled LDLcholesterol sufficiently based on Japanese guidelines. Conclusion: To optimize pharmacotherapy for dyslipidemias, medical staff should assess risk factors for CHD more completely and attempt to achieve full control of serum lipids, particularly in patients at high risk for CHD.