Management of hypercholesterolemia in a family practice setting.
A study was undertaken to assess physician adherence and patient compliance with the National Cholesterol Education Program guidelines for the management of newly detected hypercholesterolemia. The study site was the Department of Family Medicine, Medical University of South Carolina, Charleston, a university-based family medicine residency program. All serum cholesterol levels measured between July 1, 1988, and September 30, 1988, were reviewed. Patients were classified as normal, borderline, or hypercholesterolemic based on serum cholesterol levels and coronary heart disease risk factors. Patients previously recognized to be hypercholesterolemic were excluded. Six months later, medical record reviews were performed for the 192 hypercholesterolemic and 107 borderline hypercholesterolemic patients. Only 39 of the hypercholesterolemic patients (20%) had received appropriate dietary therapy and follow-up. Patient compliance with physician recommendations was excellent. There was minimal unnecessary testing or treatment of borderline hypercholesterolemia. Low rates of appropriate management of hypercholesterolemia may be related to inadequate physician knowledge, low physician-perceived self-efficacy regarding dietary counseling, or time constraints.
Levin
S J
SJ
Department of Family Medicine, Medical University of South Carolina, Charleston.
Ornstein
S M
SM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002784:Cholesterol / Q000097:blood; D005180:Faculty, Medical; D005194:Family Practice / Q000193:education; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000175:diagnosis / Q000628:therapy*; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D013022:South Carolina
D002784:Cholesterol