Practice patterns in treating high-risk patients with hyperlipidemia at a northeast Tennessee university clinic.
BACKGROUND
This study was conducted to test the hypothesis that internal medicine residents at a northeast Tennessee university clinic were not compliant with the latest National Cholesterol Educational Program Adult Treatment Panel (NCEP-ATP) guidelines in treating hyperlipidemia in patients with diabetes and coronary artery disease.


METHODS
A retrospective medical record survey was conducted to evaluate residents' pattern in lowering low-density lipoprotein (LDL) cholesterol to below 100 mg/dL in patients with diabetes and coronary artery disease. The survey covered a 5-year period, from July 1998 to June 2003, and included 15 randomly chosen residents who were in training for 3 consecutive years. Charts were randomly selected from residents' clinics using International Classification of Diseases-9 codes for coronary artery disease or diabetes mellitus with hyperlipidemia. Five hundred fifty charts were reviewed. Only 41 (7.45%) met the inclusion criteria.


RESULTS
Analysis of data using Epi-Info 2002 (Centers for Disease Control and Prevention, Atlanta, GA) revealed that only 68.3% of patients with diabetes and coronary artery disease reached target LDL cholesterol levels. Of the patients who reached target levels, only 42.9% maintained them. Analysis of variance and chi-square tests revealed that the frequency of cholesterol measurement, but not the frequency of physicians' visits, was associated with a higher likelihood of reaching the target LDL level.


CONCLUSIONS
There was a suboptimal compliance among internal medicine residents in the frequency of screening for, reaching, and maintaining the target LDL cholesterol level, according to the latest NCEP-ATP guidelines, among high-risk patients with hyperlipidemias.
Ismail
Hassan M
HM
Department of Internal Medicine, East Tennessee State University/James Quillen College of Medicine, Johnson City, TN 37604, USA. ismail@etsu.edu
Simmons
Christina
C
Pfortmiller
Deborah
D
D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000150:complications / Q000453:epidemiology; D048909:Diabetes Complications / Q000097:blood / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006785:Hospitals, University; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012306:Risk; D013714:Tennessee / Q000453:epidemiology
D008078:Cholesterol, LDL