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. 2017 Oct 25;7(10):e017817.
doi: 10.1136/bmjopen-2017-017817.

An enquiry based on a standardised questionnaire into knowledge, awareness and preferences concerning the care of familial hypercholesterolaemia among primary care physicians in the Asia-Pacific region: the "Ten Countries Study"

Jing Pang  1 , Miao Hu  2 , Jie Lin  3 , Takashi Miida  4 , Hapizah M Nawawi  5 , Jeong Euy Park  6 , Xue Wu  3 , Anis S Ramli  5 , Ngoc Thanh Kim  7   8 , See Kwok  9   10 , Lourdes E Gonzalez-Santos  11 , Ta-Chen Su  12 , Thanh Huong Truong  7   8 , Handrean Soran  10 , Shizuya Yamashita  13   14 , Brian Tomlinson  2 , Gerald F Watts  1   15
Affiliations

An enquiry based on a standardised questionnaire into knowledge, awareness and preferences concerning the care of familial hypercholesterolaemia among primary care physicians in the Asia-Pacific region: the "Ten Countries Study"

Jing Pang et al. BMJ Open. .

Abstract

Objective: To determine physicians' knowledge, awareness and preferences regarding the care of familial hypercholesterolaemia (FH) in the Asia-Pacific region.

Setting: A formal questionnaire was anonymously completed by physicians from different countries/regions in the Asia-Pacific. The survey sought responses relating to general familiarity, awareness of management guidelines, identification (clinical characteristics and lipid profile), prevalence and inheritance, extent of elevation in risk of cardiovascular disease (CVD) and practice on screening and treatment.

Participants: Practising community physicians from Australia, Japan, Malaysia, South Korea, Philippines, Hong Kong, China, Vietnam and Taiwan were recruited to complete the questionnaire, with the UK as the international benchmark.

Primary outcome: An assessment and comparison of the knowledge, awareness and preferences of FH among physicians in 10 different countries/regions.

Results: 1078 physicians completed the questionnaire from the Asia-Pacific region; only 34% considered themselves to be familiar with FH. 72% correctly described FH and 65% identified the typical lipid profile, with a higher proportion of physicians from Japan and China selecting the correct FH definition and lipid profile compared with those from Vietnam and Philippines. However, less than half of the physician were aware of national or international management guidelines; this was significantly worse than physicians from the UK (35% vs 61%, p<0.001). Knowledge of prevalence (24%), inheritability (41%) and CVD risk (9%) of FH were also suboptimal. The majority of the physicians considered laboratory interpretative commenting as being useful (81%) and statin therapy as an appropriate cholesterol-lowering therapy (89%) for FH management.

Conclusions: The study identified important gaps, which are readily addressable, in the awareness and knowledge of FH among physicians in the region. Implementation of country-specific guidelines and extensive work in FH education and awareness programmes are imperative to improve the care of FH in the region.

Keywords: Asia-Pacific; awareness; familial hypercholesterolaemia; knowledge; models of care; perception; physicians; practices.

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Conflict of interest statement

Competing interests: All authors have completed the Unified Competing Interest form. TM reports grants from JSPS during the conduct of the study; grants from Denka-Seiken, Shino-test, MSD and Otsuka outside the submitted work and honoraria from Sanofi, Astellas-Amgen, Astra Zeneka, Otsuka, Takeda, Kowa, Denka-Seiken, Sekisui-Medical, Kyowa Medex and Wako. HS reports research grants from Alexion, Amgen, MSD and Pfizer and personal fees and education grants from Aegerion, Amgen, Janssen Cilag Ltd, MSD, Pfizer, Novo Nordisk and Sanofi. SY reports grants and personal fees from Kowa, Otsuka, Shionogi, Bayer Yakuhin, MSD, Takeda, Sanwa Kagaku Kenkyusho, Astellas, Daiichi-Sankyo, Astra Zeneca and Kaken; grants from Nippon BoehringerIngelheim, Kyowa Medex, Mochida, Hayashibara, Teijin, Kissei and National Institute of Biomedical Innovation and personal fees from Medical Review Co., Skylight Biotech, Pfizer, Bristol-Meyers, Astellas-Amgen, Sanofi, Agerion and ToaEiyou, outside the submitted work. In addition, SY has two pending patents, Fujirebio and Kyowa Medex. BT reports grants and personal fees from Amgen; grants from AstraZeneca, Merk Sharp & Dohme, Novartis, Pfizer and Roche; personal fees from Merck Serono and Sanofi, outside the submitted work. GFW reports grants from Sanofi/Regeneron during the conduct of the study; grants and personal fees from Sanofi /Regeneron and Amgen; personal fees from Gemphire and Kowa, outside the submitted work. JP, MH, JL, HMN, JEP, XW, ASR, NTK, SK, LEG and THT have nothing to disclose.

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