FPs Report Practice Patterns for Hyperlipidemia

By News Staff
2/22/2006

Family physicians follow some but not all guidelines for identifying and treating patients with hyperlipidemia, say researchers in the January-February issue of the Journal of the American Board of Family Medicine.

More than 40 million Americans are estimated to have lipid disorders that are not optimally treated, say the authors of "Family Physician's Knowledge, Beliefs and Self-Reported Practice Patterns Regarding Hypderlipidemia: A National Research Network (NRN) Survey."

In April 2001, the National Cholesterol Education Program developed consensus guidelines for treatment of high blood cholesterol in adults and released the third report of the Adult Treatment Panel. The ATP III guidelines form the basis for this study by family physicians from Brown University, Pawtucket, R.I.; the University of Wisconsin, Madison; and the University of Chicago, and by staff members from the AAFP National Research Network.

The authors received usable surveys from 641 AAFP members (a 56 percent response rate) and used the information to assess adherence in 2003 to the 2001 ATP III guidelines. Among the results:

92 percent of respondents said they usually or always assessed patients for cardiovascular disease risk factors using a history and a lipid profile, however, only 11 percent reported using a team approach;
17 percent of respondents said they usually or always used a coronary heart disease risk calculator; and
36 percent said they usually or always used a system-based approach, such as a flow sheet.

"We found general agreement on universal screening of adults for hyperlipidemia as part of cardiovascular disease prevention strategy and use of LDL (low-density lipoprotein) cholesterol as a treatment goal, especially for diabetics and patients with established coronary and noncoronary atherosclerotic disease," say the authors.

Many other aspects of the NCEP ATP III guidelines -- such as using a systematic, multidisciplinary approach; using non-high-density lipoprotein cholesterol as a secondary goal for patients; using a coronary heart disease risk calculator to guide cholesterol management; and using combination therapy for patients not at their LDL goals -- "have not yet penetrated self-reported clinical practice," say the authors. "This insight may be helpful in designing quality improvement projects aimed at improving optimal cholesterol management in primary care."

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