Clinical Epidemiology and Global Health最新文献

{"title":"Decoding the drivers of healthcare utilization: The role of illness burden, lifestyle and household factors in rural North Karnataka, India","authors":"Sanjeev Chougule ,&nbsp;Padmaja Walvekar ,&nbsp;Annapurna Kari","doi":"10.1016/j.cegh.2026.102308","DOIUrl":"10.1016/j.cegh.2026.102308","url":null,"abstract":"<div><h3>Background</h3><div>Healthcare utilization in rural India remains uneven despite expansion of public health infrastructure. Identifying factors associated with healthcare-seeking is essential to strengthen service delivery. This study assessed the burden of illness and examined household, lifestyle, and health-related factors associated with healthcare utilization in rural North Karnataka.</div></div><div><h3>Methods</h3><div>A community-based cross-sectional study was conducted among 1400 adults selected through a cluster-stratified sampling design. Healthcare utilization was defined as at least one visit to a formal healthcare facility within the preceding six months. Data were collected using a structured questionnaire. Multivariable logistic regression with cluster-adjusted robust standard errors was used to identify factors associated with healthcare utilization.</div></div><div><h3>Results</h3><div>Approximately two-thirds of participants reported healthcare utilization within the previous six months. In adjusted analyses, the presence of an elderly household member (AOR: 3.42; 95% CI: 2.15–5.43), hypertension (AOR: 2.18; 95% CI: 1.41–3.36), and diabetes mellitus (AOR: 1.61; 95% CI: 1.10–2.35) were independently associated with higher healthcare utilization. Ever use of tobacco was associated with lower utilization (AOR: 0.69; 95% CI: 0.50–0.96). Disability status was not independently associated after adjustment.</div></div><div><h3>Conclusion</h3><div>Healthcare utilization in rural North Karnataka was primarily associated with household context and chronic disease burden rather than individual demographic characteristics. These findings highlight population groups that may benefit from targeted health education, chronic disease management, and outreach services. Longitudinal studies are warranted to further examine causal pathways.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102308"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Palliative care: Evaluation of knowledge, experience and confidence among physicians in a university outpatient setting","authors":"Pedro de A.Young ,&nbsp;Aline M. de O.Rocha ,&nbsp;Simone B. de O. Iglesias ,&nbsp;Maria W.L. Strufaldi","doi":"10.1016/j.cegh.2026.102310","DOIUrl":"10.1016/j.cegh.2026.102310","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric Palliative Care (PPC) is essential for improving the quality of life of children with life-threatening or life-limiting conditions and their families. Despite its growing relevance, PPC remains underexplored in medical education and clinical practice, particularly among general pediatricians.</div></div><div><h3>Objective</h3><div>This study aims to describe and analyze physicians' knowledge of Pediatric Palliative Care and identify gaps to improve the provision of such care.</div></div><div><h3>Materials and methods</h3><div>A cross-sectional study was conducted using an online questionnaire to collect both qualitative and quantitative data. The study population included physicians affiliated with the Department of Pediatrics at an undergraduate institution.</div></div><div><h3>Results</h3><div>A total of 74 completed questionnaires were analyzed. Although 88% of participants had cared for terminally ill pediatric patients, 65% reported having little or no experience in PPC. Furthermore, 86.5% had not received any formal education on PPC during their undergraduate training. While a majority felt comfortable discussing chronic disease diagnoses (59%) and participating in multidisciplinary PPC discussions (57%), many expressed limited confidence in key areas: explaining PPC to families (72%), managing pediatric pain (81%), performing pain assessment and treatment in terminally ill patients (84%), adopting a holistic psychological approach (77%), and communicating bad news or planning palliative care (70%).</div></div><div><h3>Conclusion</h3><div>The findings reveal a significant self-perceived lack of training and preparedness among pediatricians regarding PPC, despite frequent clinical encounters with patients requiring such care. These results underscore the urgent need to integrate structured PPC education into pediatric training programs to enhance the quality and effectiveness of care provided.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102310"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The state of disease research in the Middle East and North Africa from 1980 to 2023","authors":"Georges Choueiry ,&nbsp;Sola Aoun Bahous ,&nbsp;Pierre-Marie Preux ,&nbsp;Pascale Salameh ,&nbsp;Farid Boumediene","doi":"10.1016/j.cegh.2026.102316","DOIUrl":"10.1016/j.cegh.2026.102316","url":null,"abstract":"<div><h3>Background</h3><div>The production of disease research in the Middle East and North Africa (MENA) increased in recent decades. However, gaps remain in understanding the topics covered, study designs, funding sources, and institutional involvement. Our objective is to assess the state of disease research in MENA over the past 44 years and identify strengths, challenges, and opportunities for improvement.</div></div><div><h3>Methods</h3><div>We identified 300,417 PubMed articles affiliated to the MENA region, published between 1980 and 2023, including at least one MeSH term (or keyword) linked to a disease from the Global Burden of Disease database. Our analysis covered research topics, study designs, funding, collaborations, and institutional contributions.</div></div><div><h3>Results</h3><div>Top research areas included respiratory diseases (16.0%), cardiovascular diseases (10.9%), and neurological disorders (9.6%). Most studies were analytical (48.6%) and the top funder was the United States. We found that information on local funding is severely underrepresented in PubMed. High levels of international collaboration were seen, particularly in respiratory diseases, but large producers like Iran and Turkey had limited international collaborations. The COVID-19 pandemic had a positive impact on overall disease research production, increasing it by 59.2% between 2019 and 2023.</div></div><div><h3>Conclusion</h3><div>This study highlights strengths and challenges in disease research across MENA and emphasizes the need for tailored strategies to improve its quantity and quality. Despite the growth in output, our findings show dependency, inequality, and misalignment. As U.S. funding faces pressure, the sustainability of research depends on the efforts of each country to align its agenda with its own needs.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102316"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between postpartum depression and exclusive breastfeeding practices among urban mothers, Bhubaneswar, Odisha","authors":"Deepanjali Behera ,&nbsp;Manasmruti Sahu ,&nbsp;Manas Ranjan Behera ,&nbsp;Magnus Micchael Sichalwe ,&nbsp;Manatee Jitanan ,&nbsp;Janmejaya Samal ,&nbsp;Ranjit Kumar Dehury ,&nbsp;Damodar Jena","doi":"10.1016/j.cegh.2025.102259","DOIUrl":"10.1016/j.cegh.2025.102259","url":null,"abstract":"<div><h3>Problem considered</h3><div>Postpartum depression (PPD) involves persistent sadness, fatigue, and bonding difficulties, while exclusive breastfeeding (EBF) means feeding infants only breast milk for six months. Both are vital for maternal and child health, yet their relationship is understudied. This study examined the prevalence of PPD among mothers in urban Bhubaneswar, Odisha, and its association with EBF.</div></div><div><h3>Methods</h3><div>An analytical cross-sectional study was conducted among 107 postpartum mothers in urban Bhubaneswar from February to April 2024. A pre-designed questionnaire captured socio-demographic characteristics and breastfeeding practices. Data were analyzed using SPSS version 27. Univariate analysis described variables, bivariate analysis assessed associations between categorical variables, and multivariate analysis identified predictors of postpartum depression at a significance level of p ≤ 0.05.</div></div><div><h3>Results</h3><div>Among the mothers surveyed, 12.1 % reported postpartum depression, while 94.4 % practiced exclusive breastfeeding. Cesarean delivery was associated with over fourfold higher odds of depression compared to vaginal delivery (AOR = 4.41, 95 % CI: 2.19–16.27, p = 0.001). Mothers who planned to breastfeed for ≤12 months (AOR = 5.34, 95 % CI: 1.07–26.61, p = 0.04) and those intending 12–24 months (AOR = 10.28, 95 % CI: 1.14–93.14, p = 0.03) also had significantly greater odds of postpartum depression compared to those planning &gt;24 months.</div></div><div><h3>Conclusion</h3><div>Postpartum depression is linked to normal vaginal delivery and shorter planned breastfeeding durations. Early screening and breastfeeding support are essential to improve maternal mental health and infant care.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102259"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing the childbirth experience of mothers underwent labour induction in Northwest Ethiopia: A Mixed-methods Study","authors":"Srawork Tesfaye ,&nbsp;Endeshaw Admasu ,&nbsp;Eden Bishaw Taye ,&nbsp;Mengstu Melkamu Asaye","doi":"10.1016/j.cegh.2026.102296","DOIUrl":"10.1016/j.cegh.2026.102296","url":null,"abstract":"<div><h3>Background</h3><div>Induction of labor is an obstetric intervention. It can be a significant biomedical and psychosocial event, resulting in a range of positive or negative childbirth experiences. Gaining in-depth knowledge in these areas may help improve the quality of care and the utilization of maternity services. However, in Ethiopia, no studies have been conducted to date.</div></div><div><h3>Objective</h3><div>To assess mothers’ childbirth experiences and influencing factors among those who underwent induction of labor.</div></div><div><h3>Methods</h3><div>A facility-based mixed-methods study was conducted from 5 May to August 20, 2025 among 422 mothers. Data were collected using contextualized tools. Audio transcription and translation were performed for the qualitative data. Logistic regression analysis was used, with a P-value of less than 0.05 considered significant. Thematic analysis was applied to the qualitative data.</div></div><div><h3>Results</h3><div>The proportion of positive childbirth experiences was 236 (55.9 %) (95 % CI: 51.2–60.7). Being multiparous (AOR = 8.63, 95 % CI: 5.21–14.27), having a vaginal delivery (AOR = 2.11, 95 % CI: 1.31–3.41), age under 20 (AOR = 4.65, 95 % CI: 1.53–14.13), and age 21–30 (AOR = 2.35, 95 % CI: 1.22–4.51) were associated factors. The identified facilitators were trust building at admission, clear communication, and labour pain coping strategies. In contrast, feeling disturbed and lack of involvement were barriers that negatively affected mothers' childbirth experiences.</div></div><div><h3>Conclusion</h3><div>The proportion of positive childbirth experiences was moderate. Building trust, clear communication with healthcare providers, and strategies to manage labour pain were facilitators. Emotional disturbances and lack of involvement were barriers to a positive childbirth experience.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102296"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and correlates of metabolic syndrome in type 2 diabetes patients: A cross sectional study at the provincial diabetes center in Meknes, Morocco","authors":"Daoud Daoudi ,&nbsp;Nouriya Elghoulam ,&nbsp;Nadia El Mahri ,&nbsp;Aichetou Bouh ,&nbsp;Youssef Aboussalah ,&nbsp;Abdellah Zinedine ,&nbsp;Saber Boutayeb ,&nbsp;Souad Benaich ,&nbsp;Slimane Mehdad","doi":"10.1016/j.cegh.2026.102320","DOIUrl":"10.1016/j.cegh.2026.102320","url":null,"abstract":"<div><h3>Problem considered</h3><div>Metabolic syndrome (MetS) is a key contributor to cardiovascular complications among adults with type 2 diabetes (T2D). However, information regarding the prevalence and factors related to MetS among adults with T2D is scarce in Morocco. The aim of this study was to estimate the prevalence of MetS and identify the risk and protective factors among adults with T2D in Meknes, Morocco.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 425 adult patients with T2D attending the provincial diabetes center in Meknes, Morocco. Data were collected using structured questionnaires and medical records. MetS was defined using the 2009 harmonized IDF/AHA/NHLBI criteria.</div></div><div><h3>Results</h3><div>Overall, 72.9% of participants met the criteria for MetS, with a higher prevalence in women (81.2%) than men (58.4%; p &lt; 0.001). Overweight and obesity were the strongest risk factors (AOR = 14.25; 95% CI: 6.77–29.96; p &lt; 0.001), followed by insufficient sleep (AOR = 2.44; p = 0.004) and a family history of cardiovascular disease (AOR = 2.64; p = 0.004). Protective factors included male sex (AOR = 0.13; p &lt; 0.001), rural residence (AOR = 0.51; p = 0.029), higher education (AOR = 0.20; p = 0.029), adherence to the Mediterranean diet (AOR = 0.23; p = 0.003), and moderate to high physical activity (AOR = 0.23–0.31; p ≤ 0.022).</div></div><div><h3>Conclusion</h3><div>MetS is very common among adults with T2D in Meknes, with most risk factors being modifiable. There is a need for targeted interventions, especially among women, urban dwellers, and those with lower education, to reduce the burden of MetS.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102320"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of health insurance in shaping cesarean section rates among Indonesian women","authors":"Agung Dwi Laksono ,&nbsp;Ratna Dwi Wulandari","doi":"10.1016/j.cegh.2026.102313","DOIUrl":"10.1016/j.cegh.2026.102313","url":null,"abstract":"<div><h3>Background</h3><div>Understanding how health insurance ownership is associated with cesarean section delivery is essential for assessing maternal health service utilization in Indonesia. This study examines the relationship between insurance type and cesarean delivery among Indonesian women, while accounting for the national survey design.</div></div><div><h3>Methods</h3><div>This study used secondary data from the 2023 Indonesian Health Survey, including 70,916 women who delivered within five years preceding the survey. Complex survey adjusted logistic regression was applied to account for the multistage and stratified sampling design. Health insurance ownership was categorized as uninsured, government-run, private-run, or hybrid. Adjusted odds ratios and predicted probabilities were estimated. Firth's penalized likelihood regression was conducted as a sensitivity analysis for the hybrid insurance group.</div></div><div><h3>Results</h3><div>Overall, 25.9% of women reported cesarean delivery. After survey adjustment, cesarean delivery was more prevalent among insured women than uninsured women. Predicted probabilities indicated a higher absolute probability of cesarean delivery among women with government-run, private-run, and hybrid insurance. Estimates for the hybrid insurance group were consistent in direction but should be interpreted cautiously due to the small sample size.</div></div><div><h3>Conclusion</h3><div>Health insurance ownership is associated with higher cesarean delivery rates in Indonesia. These findings reflect associations rather than causal effects and may be influenced by differences in clinical risk profiles and health system factors.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102313"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147397808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health and quality of life in older adults in southern Peru: A cross-sectional study","authors":"Carolina Cueto Chavez ,&nbsp;Stephanie Echevarria-Dulanto ,&nbsp;Sheein Vega Rojas ,&nbsp;Javier Flores-Cohaila ,&nbsp;Cesar Copaja-Corzo ,&nbsp;Brayan Miranda-Chavez","doi":"10.1016/j.cegh.2025.102276","DOIUrl":"10.1016/j.cegh.2025.102276","url":null,"abstract":"<div><h3>Problem considered</h3><div>Mental health disorders in older adults significantly impair quality of life; however, data from urban primary care in Peru is scarce. Therefore, our objective was to analyze mental health and its association with quality of life in older adults in a city in southern Peru.</div></div><div><h3>Methods</h3><div>A cross-sectional study evaluated 500 older adults randomly selected from the Ciudad Nueva Health Center in Tacna. Depressive symptoms (PHQ-9), anxiety symptoms (GAD-7), and health-related quality of life (EQ-5D-5L utility index and EQ-VAS) were measured. Sociodemographic and clinical covariates were recorded. Adjusted β coefficients and 95% confidence intervals were estimated using multiple linear regression.</div></div><div><h3>Results</h3><div>Positive screen for depression (PHQ-9 ≥ 10) affected 51% and positive screen for anxiety (GAD-7 ≥ 10) affected 51.4%. The mean EQ-5D-5L utility index was 0.5 ± 0.30 and the mean EQ-VAS score was 65.8 ± 17.9. In the adjusted models, the presence positive screen for depression was associated with a reduction in quality of life, reflected by a decrease in the EQ-5D-5L utility index (adjusted β = −0.28; 95% CI: −0.36 to −0.20). Additionally, both being retired and receiving a salary or wage were independently associated with reductions in the EQ-5D-5L utility index (adjusted β = −0.11; 95% CI: −0.20 to −0.02 and adjusted β = −0.11; 95% CI: −0.20 to −0.02, respectively).</div></div><div><h3>Conclusion</h3><div>High depression rates were associated with markedly lower quality of life in this Peruvian geriatric cohort, underscoring the need for integrated mental health screening and interventions.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102276"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147397837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"May Measurement Month (MMM) program 2021–2024: Results of a community screening program in can Tho city, Vietnam","authors":"Son Kim Tran ,&nbsp;Cuong Tan Vo ,&nbsp;Phuong Minh Nguyen ,&nbsp;Dung The Bui ,&nbsp;Chau Minh Tran ,&nbsp;Toan Hoang Ngo ,&nbsp;Minh Van Huynh","doi":"10.1016/j.cegh.2026.102302","DOIUrl":"10.1016/j.cegh.2026.102302","url":null,"abstract":"<div><h3>Problem considered</h3><div>Hypertension (HTN) remains one of the most pressing global health challenges, straining healthcare systems. The May Measurement Month (MMM) campaign aims to raise blood pressure (BP) awareness and address screening gaps. This study screened volunteers aged ≥18 for HTN and cardiovascular risk factors to assess prevalence, awareness, and management effectiveness.</div></div><div><h3>Methods</h3><div>This study employed a cross-sectional, opportunistic survey design. Data were collected from adults aged ≥18 years between 2021 and 2024 as part of the MMM initiative.</div></div><div><h3>Results</h3><div>Among 4105 participants (mean age 53.0 ± 15.3 years), 37.2 % had HTN. Of untreated individuals, 72.5 % were hypertensive, while 53.4 % of treated cases remained uncontrolled (BP ≥ 140/90 mmHg). HTN prevalence rose from 28.9 % (2021) to 47.8 % (2024), with BP control improving to 46.5 % (p &lt; 0.001). HTN was highest in ≥60 years (46.8 %) and lowest in &lt;45 years (15.4 %), while BP control remained stable (33.5 %–35.1 %). Males had higher HTN prevalence, though BP control differences were not significant (p &gt; 0.05). In univariate analyses, HTN was associated with smoking, alcohol use, overweight–obesity, pregnancy, and cardiovascular comorbidities. In the multivariate model from MMM 2021–2024, independent contributors to HTN included older age, heart attack, stroke, diabetes, and physical inactivity, whereas smoking and male sex did not retain statistical significance.</div></div><div><h3>Conclusion</h3><div>The MMM 2021–2024 campaign, conducted during COVID-19, highlighted the need for BP screening in Vietnam. Despite pandemic challenges, undiagnosed and uncontrolled HTN remain major concerns. Standardized screening like MMM remains crucial for detecting high BP and improving HTN management.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102302"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LDL-cholesterol goal achievement and guideline adherence among middle-to older-age Irish adults in a primary care setting","authors":"Rehab Elhiny ,&nbsp;Linda M. O'Keeffe ,&nbsp;Seán R. Millar ,&nbsp;Stephen Byrne ,&nbsp;Margaret Bermingham ,&nbsp;Maria Donovan","doi":"10.1016/j.cegh.2026.102286","DOIUrl":"10.1016/j.cegh.2026.102286","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102286"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}