Management erhöhter Cholesterinwerte in der Praxis — Ergebnisse einer Befragung niedergelassener Primärärzte

Summary

In connection with a large population screening (N=24317) in Bielefeld/Federal Republic of Germany a physicians inquiry has been carried out with a return of 55 out of 105 general practitioners or internists (52,4%), about 60% practising already more than 10 years in Bielefeld. Only 42% of the answering physicians determine cholesterol in every new patient. Only 13% used own laboratory equipment, only 4% dry chemistry (almost indispensable for screening purposes). About 35% consider cholesterol lowering drug therapy to be necessary only beyond values of 300 mg/dl total cholesterol, the mean borderline value for the prescription of cholesterol lowering drugs was 265 mg/dl. Especially positions of shorter practice experience seemed to be sceptical taughts pharmacological means. The most utilized pharmacological preparations in Bielefeld correspond well with the “Arzneiverordnungs-Report '88”. Side effects seem to be frequent as only three positions indicated that none of the patients under drug therapy had reported unwanted effects. Most physicians considered dietary therapy to be less effective than drug therapy. Almost all of them took means to increase the compliance of their patients, mainly (82%) through at least threemonthly consultations. The prevalence of patients under cholesterol lowering dietary or pharmacologic therapy varied from 5 to 65% with the median of 17,5% which indicates a considerable underdetection of cases. However, physicians seem to be conscious about that as almost 80% hold more public information on cholesterol for desirable or (60%) very desirable.