LDL-cholesterol goal achievement and guideline adherence among middle-to older-age Irish adults in a primary care setting

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dc.contributor.authorElhiny, Rehab
dc.contributor.authorO'Keeffe, Linda M.
dc.contributor.authorMillar, Seán R.
dc.contributor.authorByrne, Stephen
dc.contributor.authorBermingham, Margaret
dc.contributor.authorDonovan, Maria
dc.contributor.funderLivinghealth Clinic
dc.contributor.funderMinistry of Higher Education and Scientific Research, MHESR
dc.contributor.funderCultural Affairs and Mission Department
dc.contributor.funderHealth Research Board, HRB, HRC/2007/13
dc.date.accessioned2026-02-20T12:50:02Z
dc.date.available2026-02-20T12:50:02Z
dc.date.issued2026-01-07
dc.description.abstractBackground A significant gap exists between recommended low-density lipoprotein cholesterol (LDL-C) treatment goals and the achievement of these goals in clinical practice. In addition, there remains suboptimal utilization of lipid-lowering therapies (LLT). This study examines the prescribing pattern of LLT and the level of LDL-C goal achievement among Irish adults in a primary care setting. In addition, it identifies patient factors associated with the prescribing of LLT and LDL-C goal achievement. Methods This was a cross-sectional analysis of rescreen data from the Mitchelstown Cohort Study. Demographic, medication and diagnosis data were obtained from participant electronic health records. Cardiovascular risk was assessed using the SCORE tool. LDL-C goal achievement was determined using the LDL-C goals set out in the 2011 ESC/EAS guidelines for the management of dyslipidemia. Results Among 1183 participants (median age = 65 years), 48.5 % were prescribed LLT, 42 % of whom attained their LDL-C goal. Only 17.5 % were prescribed high-intensity statin therapy and 13 % were prescribed combination therapy. In multivariable analysis, diabetes history, polypharmacy, and hyper-polypharmacy were associated with prescribing LLT. Being male or ≤59 years of age was associated with lower likelihood of LLT prescription. Target LDL-C goal achievement was associated with male sex and age ≤64 or ≥70 years, while BMI 25–29 kg/m2 was associated with lower LDL-C goal achievement. Conclusion Dyslipidemia is undertreated in this Irish primary care population with limited use of high-intensity statins. This study highlights the gap between guideline recommendations for LLT prescription and LDL-C target goals and real-world implementation of guidelines.en
dc.description.sponsorshipFunding for this work was received from Novartis Ireland Ltd
dc.description.sponsorshipMs. Elhiny is a recipient of a Graduate Studies Scholarship from the Cultural Affairs and Mission Department, Ministry of Higher Education and Scientific Research, Cairo, Egypt. The Mitchelstown Cohort Study was supported by a research grant to the HRB Centre for Health and Diet Research from the Irish Health Research Board (reference HRC/2007/13). The authors would like to acknowledge the Livinghealth Clinic, Mitchelstown, County Cork, Ireland and would like to thank all members of the Mitchelstown cohort for their valuable contribution to this study. Their participation is much appreciated. Funding for this work was received from Novartis Ireland Ltd
dc.description.sponsorshipMs. Elhiny is a recipient of a Graduate Studies Scholarship from the Cultural Affairs and Mission Department, Ministry of Higher Education and Scientific Research, Cairo, Egypt . The Mitchelstown Cohort Study was supported by a research grant to the HRB Centre for Health and Diet Research from the Irish Health Research Board (reference HRC/2007/13).
dc.description.versionPublished Version
dc.format.extent7
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid102286
dc.identifier.authororcidElhiny, Rehab
dc.identifier.authororcidO'Keeffe, Linda M.
dc.identifier.authororcidMillar, Seán R.§0000-0003-4453-8446
dc.identifier.authororcidByrne, Stephen§0000-0003-3141-7004
dc.identifier.authororcidBermingham, Margaret§0000-0002-8692-1569
dc.identifier.authororcidDonovan, Maria§0000-0003-0555-7492
dc.identifier.citationElhiny, R, O'Keeffe, L M, Millar, S R, Byrne, S, Bermingham, M & Donovan, M 2026, 'LDL-cholesterol goal achievement and guideline adherence among middle-to older-age Irish adults in a primary care setting', Clinical Epidemiology and Global Health, vol. 38, 102286. https://doi.org/10.1016/j.cegh.2026.102286
dc.identifier.doi10.1016/j.cegh.2026.102286
dc.identifier.issn2213-3984
dc.identifier.journaltitleClinical Epidemiology and Global Health
dc.identifier.otherORCID: /0000-0002-8692-1569/work/201746972
dc.identifier.otherORCID: /0000-0003-0555-7492/work/206318231
dc.identifier.otherORCID: /0000-0003-3141-7004/work/206318501
dc.identifier.urihttps://hdl.handle.net/10468/18556
dc.identifier.volume38
dc.language.isoen
dc.publisherElsevier B.V.
dc.relation.urihttps://www.scopus.com/pages/publications/105034544514
dc.rightsPublisher Copyright: © 2026 The Authors. Published by Elsevier B.V. on behalf of INDIACLEN. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/
dc.rights.accessrightsopen access
dc.rights.licensenameAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.statusPeer reviewed
dc.subjectCholesterol
dc.subjectDrug prescriptions
dc.subjectDyslipidemias
dc.subjectHeart disease risk factors
dc.subjectHydroxymethyl glutaryl-CoA reductase inhibitors
dc.subjectLDL
dc.subjectLDL-C control
dc.subject[Pharmacy]
dc.subject[PublicHealth]
dc.titleLDL-cholesterol goal achievement and guideline adherence among middle-to older-age Irish adults in a primary care settingen
dc.typeArticle (peer-reviewed)
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