Patterns of physicians' treatments for referral patients from public cholesterol screening

Current interest in high blood cholesterol and attendance at public cholesterol screening programs has raised the issue of whether physicians are responding to referrals according to existing national assessment and treatment recommendations. This study assessed the relationship of characteristics of referrals from a series of public blood cholesterol screenings to physicians' treatment practices. For this analysis, the sample was restricted to 1,324 subjects, from the 2,109 referred, who reported seeking physician care. At five months after screening, 75% of subjects reported their physician prescribed a diet; 16% of physicians prescribed medication. Multiple logistic regression, adjusted for sociodemographic characteristics and other coronary heart disease (CHD) risk factors, indicated that screening cholesterol risk level, prior history of high blood cholesterol levels, and type of medical contact were consistently related to receipt of diet and medication treatment, but other CHD risk factors were underutilized. 'Moderate' risk subjects with no history of high blood cholesterol were less likely to have received dietary advice, but a screening-risk level interaction did not occur for medication. The results imply that current treatment guidelines may not be working and suggest the need for continued physician education in the management of hypercholesterolemia.