薬理と治療

Abstract

Background and Objectives　Persistence rate of treatment in dyslipidemia is lower than that of other non-communicable diseases. We aim to investigate the reasons for discontinuation by drug categories（statins, polyunsaturated fatty acid, fibrates and small intestine cholesterol transporter inhibitor）and clarify the consciousness gap in dyslipidemia, treatment and medication between doctors and patients. Methods　Web-based questionnaires toward doctors and patients. Results　Answers from 504 doctors and 1547 patients were analyzed. Among the reasons for discontinuation,“Adverse effect” is high in statins and fibrates but low in other drug categories. “Lack of efficacy” is higher in other drug categories than in statins. In all drug categories, “dropout of outpatients”is high among doctors; by contrast “unknown”and“unnecessary for medication”are high among the patients. In contrast to more than 90％ of the doctors said they are giving instructions on diet and exercise therapies, 55％ of the patients answered they are receiving instruction. There was a difference in the recognition between doctors and patients as to who in the medical staff takes care of patientsʼ diet and exercises as well as checking their daily life and compliance. Conclusions　Both surveys show the difference in the percentage of“Adverse effect”and “Efficacy”among reasons for discontinuation by each drug category. Unclear reasons are identified in all drug categories, which seems due to an insufficient communication between doctors and patients. There is a gap in consciousness about management of patientsʼ daily life and compliance. A follow-up including daily life management is important for a better adherence of treatment.