Management of Hypercholesterolemia: Practice Patterns for Primary Care Providers and Cardiologists

Bramlet, Dean A.; King, Helen; Young, Lanette D.; Witt, Jeffrey R.; Stoukides, Cheryl A.; Kaul, Alan F.

doi:10.1016/s0002-9149(97)00819-9

Cited by 44 publications

(36 citation statements)

References 9 publications

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“…23 This may be especially true for primary care physicians who must deal with several chronic conditions in addition to any acute symptoms that patients manifest at any given office visit. 21,24 Choice, under such circumstances, may more likely be determined by physician attitudes and beliefs as well as the interaction of these attitudes and beliefs with those of the patient when shared decision-making is sought. The highly significant association of several physician attitudes and beliefs with the decision to increase the statin dose in this study provides evidence that this may very well be part of the explanation.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Physician Attitudes and Beliefs on Treatment Decisions

Foley¹,

Denke

Kamal-Bahl³

et al. 2006

Medical Care

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Section: Discussionmentioning

confidence: 99%

The Impact of Physician Attitudes and Beliefs on Treatment Decisions

Foley¹,

Denke

Kamal-Bahl³

et al. 2006

Medical Care

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“…Much effort has been invested during the past decade in demonstrating that large and comprehensive cardiac rehabilitation centres improve risk factor management and outcomes (9)(10)(11)(12). However, only a relatively small proportion of patients with established coronary artery disease (CAD) has access to these facilities (13,14), and the overall cost of these centres, while not prohibitive, is nonetheless an obstacle to their wider adoption.…”

Section: Objectives and Methodsmentioning

confidence: 99%

Surveillance and treatment of dyslipidemia in the post-infarct patient: Can a nurse-led management approach make a difference?

Lapointe

Lepage

Larrivée

et al. 2006

Canadian Journal of Cardiology

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“…and Bramlet et al. have compared the effects of these programs on lipid levels between women and men 97,99 …”

Section: Limitations Of Solutions For Suboptimal Screening and Treatmentmentioning

confidence: 99%

Review of evidence and explanations for suboptimal screening and treatment of dyslipidemia in women

2003

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Screening and treatment rates for dyslipidemia in populations at high risk for cardiovascular disease (CVD) are inappropriately low and rates among women may be lower than among men. We conducted a review of the literature for possible explanations of these observed gender differences and categorized the evidence in terms of a conceptual model that we describe. Factors related to physicians' attitudes and knowledge, the patient's priorities and characteristics, and the health care systems in which they interact are all likely to play important roles in determining screening rates, but are not well understood. Research and interventions that simultaneously consider the influence of patient, clinician, and health system factors, and particularly research that focuses on modifiable mechanisms, will help us understand the causes of the observed gender differences and lead to improvements in cholesterol screening and management in high-risk women. For example, patient and physician preferences for lipid and other CVD risk factor management have not been well studied, particularly in relation to other gender-specific screening issues, costs of therapy, and by degree of CVD risk; better understanding of how available health plan benefits interact with these preferences could lead to structural changes in benefits that might improve screening and treatment. Women's cholesterol profile can be modified with statin therapy and the incidence of coronary events reduced. [2][3][4][5][6] However, screening and treatment rates for CVD risk factors in high-risk populations may be inappropriately low, particularly in the outpatient setting. [7][8][9] In order to identify articles that would distinguish screening and treatment of women apart from men, we searched MEDLINE for publications fitting these criteria: English language, human subjects, adults 19 years and older, and publication date during or after 1996 to allow dissemination and implementation of the ATPII guidelines released in 1993. We added the terms ( gender OR women ) AND ( therapy OR measurement OR treatment OR management ) AND ( coronary OR cardiovascular OR cardiac ) AND ( cholesterol OR lipid OR dyslipidemia OR hypercholesterolemia ), which resulted in 4019 articles; to further focus the search on management of cholesterol as opposed to pure epidemiological or mechanistic studies, we added the search term ( undertreatment OR compliance OR utilization OR adherenc e OR bias OR disparity OR guidelines ), which resulted in 541 articles. We included articles that focused on secondary prevention and outpatient management, and reported gender comparisons in screening and treatment. We excluded articles that did not have original data and did not focus on cholesterol management, resulting in 520 articles. Finally, we reviewed the reference lists of these articles and included articles that were missed in the original search ( n = 3). We abstracted the screening, therapy, and successful treatment percentages for men and women and P values or confidence intervals when av...

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Management of Hypercholesterolemia: Practice Patterns for Primary Care Providers and Cardiologists

Cited by 44 publications

References 9 publications

The Impact of Physician Attitudes and Beliefs on Treatment Decisions

The Impact of Physician Attitudes and Beliefs on Treatment Decisions

Surveillance and treatment of dyslipidemia in the post-infarct patient: Can a nurse-led management approach make a difference?

Review of evidence and explanations for suboptimal screening and treatment of dyslipidemia in women

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