Abstract
Objective:To study knowledge of and adherence to National Cholesterol Education Program Adult Treatment Panel (ATP) guidelines among primary care physicians.
Design:Cross-sectional telephone survey.
Setting:New York State primary care practitioners; survey conducted November 1988-January 1989.
Participants:Physicians in general practice, family practice, internal medicine without subspecialty, and cardiology who reported ≥10 bours/week of clinical practice (n=329; response rate = 63%).
Interventions:None.
Measurements and main results:While 84% of physicians bad beard of the ATP guidelines, gaps in knowledge and inconsistencies between ATP recommendations and clinical practices were found. Although the ATP guidelines recommend six months of dietary therapy before starting drug treatment, 41% of physicians would initiate drug treatment for a healthy 40-year-old man with total cbolesterol of 7.8 mmol/L (300 mg/dl) either at the initial visit or after one month of lipid-lowering diet. Multivariate analysis of a 24-item knowledge scale revealed that less knowledgeable physicians were more likely to be older, lack board certification, and have a specialty other than cardiology (p<0.01). Less knowledgeable physicians were also more likely to consider drug company literature and drug company representatives very useful sources of information about cholesterol (p=0.02).
Conclusion:This study suggests that bard-to-reach physician groups may require special efforts to communicate consensus guidelines of major importance to clinical practice.
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Received from the Department of Medicine and the Division of Epidemiology and Sociomedical Sciences, School of Public Health, Columbia University Health Sciences Division, New York, New York.
Supported in part by a Grant-in-aid from the American Heart Association, New York City Affiliate.
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Shea, S., Gemson, D.H. & Mossel, P. Management of high blood cholesterol by primary care physicians. J Gen Intern Med 5, 327–334 (1990). https://doi.org/10.1007/BF02600401
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DOI: https://doi.org/10.1007/BF02600401