Treatment Initiation and Modification Among Patients Diagnosed With Dyslipidemia: Prevalence and Associated Factors

Objective: Physician inertia is a critical factor in the management of uncontrolled noncommunicable diseases.This study aimed to determine the prevalence of physician inertia and the associated factors among patients with dyslipidemia.Methods: A retrospective cohort study was conducted using electronic medical records of dyslipidemia patients who received outpatient services in a northern Thailand hospital between January 1, 2021, and December 31, 2021.Physician inertia was defined as the absence of treatment intensification despite patients not achieving the target low-density lipoprotein cholesterol level.The criteria for physician inertia were based on the 2019 European Society of Cardiology guideline.Logistic regression analysis was applied to identify factors associated with physician inertia.Results: A total of 841 dyslipidemia patients who attended the outpatient department were included.The prevalence of physician inertia was 82.0%.Significant factors associated with physician inertia were female gender (adjusted odds ratio [OR], 1.54; 95% confidence interval [CI], 1.06-2.23),enrollment in the Civil Servant Medical Benefit Scheme (adjusted OR, 1.58; 95% CI, 1.06-2.37),hypertension (adjusted OR, 2.56; 95% CI, 1.69-3.87),and atherosclerotic cardiovascular disease (ASCVD) (adjusted OR, 2.75; 95% CI, 1.64-4.60). Conclusion:The prevalence of physician inertia in patients with dyslipidemia was 82.0%.Female gender, universal coverage scheme, hypertension, and ASCVD were significantly associated with physician inertia.Identifying contributors to physician inertia and developing interventions to address them may improve healthcare delivery and patient outcomes.