The awareness of lipid guidelines among physicians is high, but their use is low. The majority expressed concerns about the adverse effects of statins. Awareness of lipid guidelines and specialist training were associated with appropriate statin use.
A total of 315 physicians practising in Nigeria completed an online cross-sectional survey on statin prescription.
About two-thirds of respondents were aware of relevant lipid management guidelines, but only a minority reported regular use.
Most respondents expressed concerns about statin use, most commonly muscle disorders.
A substantial proportion of respondents withheld statins in the high-risk clinical vignette, while most prescribed them in the low-risk vignette.
Agreement between responses to the high-risk and low-risk vignettes was statistically significant but weak.
Awareness of relevant lipid guidelines was significantly associated with statin prescription in the high-risk scenario in the multivariable model.
Being a specialist showed a borderline association with lower odds of inappropriate statin prescription.
This study surveyed 315 physicians in Nigeria online to learn how they use statins, which are cholesterol-lowering drugs that reduce heart disease and death. About two-thirds knew of guidelines on managing blood lipids, but only about 28% said they used them regularly. Most (79%) worried about statin side effects, especially muscle problems, liver disease, memory problems and new diabetes. In practice-based case scenarios, nearly a quarter of doctors would not prescribe a statin for a high-risk patient who should get one, while about two-thirds would prescribe one for a low-risk patient. Doctors who were aware of the guidelines were much less likely to make errors in the high-risk case. Being a specialist hinted at fewer inappropriate prescriptions, but this was borderline and not statistically clear. This research suggests that knowing about guidelines is not enough, and that fears about side effects and inconsistent use of guidelines may contribute to under- and over-prescribing of statins. Because the data came from a self-selected online survey using hypothetical cases, it may not fully reflect real-world prescribing. The findings point to guideline awareness and training as areas to target.
Oiwoh S, Adebayo O, Inofomoh F, Shogade T, Ayoola Y, Adetunji T, et al.. (2026). Determinants of Statin Prescription among Physicians in Nigeria.. The Nigerian postgraduate medical journal. https://doi.org/10.4103/npmj.npmj_59_26