Assessment of Physician Knowledge and Practices Regarding Familial Hypercholesterolemia Screening and Management: A Survey Study

Abstract

Familial hypercholesterolemia (FH) is a hereditary illness characterized by high low-density lipoprotein (LDL) cholesterol, greatly boosting the risk of early cardiovascular diseases (CVD). This cross-sectional study assessed the knowledge, attitudes, and practices of 100 physicians in Aden, Yemen, from June to August 2023. Participants consisted of 65% females and 35% males, with 54% having more than five years of clinical experience and 56% working in private facilities. The survey revealed that 91% of physicians recognized familial hypercholesterolemia (FH) as a hereditary illness associated with elevated LDL cholesterol levels; however, only 53% were familiar with the diagnostic criteria, and 63% with the clinical detection algorithms. Routine assessment of familial hypercholesterolemia risk factors, such as a family history of early-onset cardiovascular disease, was reported by 49%, while only 28% consistently evaluated these risk factors. While 77% of physicians deemed familial hypercholesterolemia screening essential for patients with elevated LDL cholesterol, only 47% expressed confidence in identifying at-risk individuals. Physicians with more than five years of experience displayed greater awareness of familial hypercholesterolemia diagnostic criteria (60%) and were more willing to routinely assess familial risk factors (56%) compared to their less experienced counterparts (50% and 44%, respectively).
Despite significant awareness of familial hypercholesterolemia (FH) and its health implications, notable shortcomings were observed in the comprehension of diagnostic criteria, cascade screening, and adherence to screening protocols. Experienced physicians exhibited enhanced knowledge and confidence, underscoring the need of specialized training programs. Improving FH screening systems is critical for advancing patient care in Yemen and analogous countries.