Are patients with hyperlipidemia being treated? Investigation of cholesterol treatment practices in an HMO primary care setting.
BACKGROUND
The main study objective was to investigate cholesterol treatment practices of primary care physicians in a managed care setting.


METHODS
The study was a retrospective review of data with a quasiexperimental design. The National Cholesterol Education Program-Adult Treatment Panel II (NCEP-ATP II) guidelines were used as the reference for conducting a measurement model in the study. Data were randomly selected via a systematic probability sampling method from a health maintenance organization (HMO) capitated risk-based contracting medical clinic in southern Florida.


RESULTS
Of the 348 patients selected for the study, 224 (65%) needed either dietary therapy (n = 106) or drug therapy (n = 118). However, only 16 patients (13.6%) had ever had cholesterol-lowering drug regimens prescribed during the 5-year study period.


CONCLUSIONS
Our findings indicate that (1) primary care physicians have poorly adopted the cholesterol management practice recommended by NCEP guidelines and need to improve their recognition and treatment of hypercholesterolemia; and (2) the problem of underutilizing prescription medications may be associated with risk-sharing capitation arrangements between physicians and third-party insurers.
Lai
L L
LL
Department of Pharmacy Administration, Nova Southeastern University, Fort Lauderdale, Fla 33328, USA.
Poblet
M
M
Bello
C
C
D000328:Adult; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D002204:Capitation Fee; D002985:Clinical Protocols; D003327:Coronary Disease / Q000150:complications; D004363:Drug Utilization; D005260:Female; D006279:Health Maintenance Organizations; D006801:Humans; D006937:Hypercholesterolemia / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D007349:Insurance, Health, Reimbursement; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011336:Probability; D012189:Retrospective Studies; D012307:Risk Factors; D020414:Risk Sharing, Financial
D000924:Anticholesteremic Agents