Treatment of hypercholesterolemia by a clinical nurse using a stepped-care protocol in a nonvolunteer population.
National trials have demonstrated that the incidence of myocardial infarction and coronary death can be decreased, and progression of atherosclerosis delayed or reversed, by administration of bile acid-binding resins. A cholesterol clinic was established to determine whether a simple protocol would be effective in a nonvolunteer population referred by practicing cardiologists. The clinic was operated by a nurse who followed a stepped-care protocol, similar in concept to that used for treatment of hypertension. In the treatment of 86 patients with type II hyperlipidemia (cholesterol level, greater than 6.85 mmol/L [greater than 265 mg/dL]; triglyceride levels, normal or mildly elevated), compliance with the protocol resulted in reductions in cholesterol level of 19% in patients treated with diet, 23% for those treated with diet plus a bile sequestrant (colestipol hydrochloride or cholestyramine resin), and 25% in those treated with diet plus other cholesterol-lowering drugs. This method of treatment was effective and may serve as a model for the management of large numbers of patients with this condition.
Blair
T P
TP
Department of Internal Medicine, Naval Hospital, Bethesda, Md 20814.
Bryant
F J
FJ
Bocuzzi
S
S
D002791:Cholesterol, Dietary / Q000008:administration & dosage; D002985:Clinical Protocols; D003131:Combined Modality Therapy / Q000379:methods; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000178:diet therapy / Q000188:drug therapy / Q000451:nursing / Q000628:therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009720:Nurse Clinicians
D002791:Cholesterol, Dietary; D000960:Hypolipidemic Agents