Family Physician's Knowledge, Beliefs, and Self-reported Practice Patterns Regarding Hyperlipidemia: A National Research Network (NRN) Survey

Abstract

Objective: Family physicians have the potential to make a major impact on reducing the burden of cardiovascular disease through the optimal assessment and management of hyperlipidemia. We were interested in assessing the knowledge, beliefs, and self-reported practice patterns of a representative sample of family physicians regarding the assessment and management of hyperlipidemia 2 years after the release of the evidence-based National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines.Methods: A 33-item survey was mailed to a random sample (N ‫؍‬ 1200) of members of the American Academy of Family Physicians in April of 2004, with 2 follow-up mailings to nonresponders. Physicians were queried about sociodemographic characteristics, their knowledge, attitudes, and self-reported practice patterns regarding the assessment and management of hyperlipidemia. Four case scenarios also were presented.Results: Response rate was 58%. Over 90% of surveyed family physicians screened adults for hyperlipidemia as part of a cardiovascular disease prevention strategy. Most (89%) did this screening by themselves without the support of office staff, and 36% reported routine use of a flow sheet. Most had heard of the ATP III guidelines (85%), but only 13% had read them carefully. Only 17% of respondents used a coronary heart disease (CHD) risk calculator usually or always. Over 90% of those responding reported using low-density lipoprotein (LDL) as the treatment goal but only 76% reported using non-high-density lipoprotein (HDL) cholesterol as a secondary goal of therapy. Cardiovascular disease is the leading cause of death and disability in the United States and most western societies. The prevalence of cardiovascular disease is now increasing, presumably due to the aging of the population and the near epidemic rise in the prevalence of obesity and diabetes mellitus. 1,2These trends are potentially reversible with the optimal assessment and management of cardiovascular disease risk factors, of which hyperlipidemia is prominent. Well designed clinical trials have demonstrated the efficacy of pharmacologic treatment of hyperlipidemia in men and women, both middleaged and older, those with established cardiovascular disease and those without, and in all racial

Erectile Dysfunction and Cardiovascular Disease: Efficacy and Safety of Phosphodiesterase Type 5 Inhibitors in Men With Both Conditions

“…30 In another study, elevated levels of LDL-C were found as well in 114 (74.0%) of 154 elderly men with ED. 31 In a retrospective study involving 988 men (aged 46-81 years), Eaton et al 32 found that men with poor to very poor erectile function had twice the odds of an elevated TC/HDL-C ratio (P=.02) compared with men with good and very good erectile function. Thus, aggressive treatment of both ED and dyslipidemia may result in a decrease in cardiovascular events and improvement in erectile function.…”

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“…(NCEP,2002) . That could justify the higher degree of screening that was found also in a previous study that the age at which family physicians begin screening lies between the ages recommended by the ATP III guidelines and the USPSTF (Eaton et al, 2006).…”

Translating Cholesterol Guidelines Into Primary Care Practice: A Multimodal Cluster Randomized Trial

“…[7][8][9][10][11][12][13][14] Potential barriers to the implementation of cholesterol guidelines into clinical practice appear related to clinician knowledge, attitudes, and behaviors; patient knowledge, attitudes, and behaviors; doctor-patient communication issues; and system-based issues, such as economics and the lack of organized systems of care around the recognition and treatment of hyperlipidemia. [15][16][17] Thus a multimodal approach affecting clinicians, patients, doctor-patient communication, and offi ce systems (clinical decision support tools, patient education materials, offi ce waiting room computer kiosks) is likely to be needed to translate these guidelines into clinical practice.…”