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Volume 16 (4)

Volume 16, Issue 4, Fall 1996
J Contin Educ Health Prof 1996; 16(3):225-240
ORIGINAL ARTICLES

 JCEHP AWARD FOR EXCELLENCE IN RESEARCH
Full Text 

Increasing Physician Involvement in Cholesterol-Lowering Practices
Karen V. Mann, PhD
Elizabeth A. Lindsay, PhD
R. Wayne Putnam, MD
David A. Davis, MD

A b s t r a c t

The study tested a multifaceted educational intervention designed to increase physician cholesterol-lowering practices. This three-group randomized controlled trial involved 51 Nova Scotia family physicians. Seventeen group I and 19 group II physicians attended a training workshop addressing the management of elevated serum cholesterol. Supporting print materials were provided for physicians and patients. Access to consultants was provided throughout the study. Group II physicians also used a "cuing" intervention to facilitate identification of eligible patients. Fifteen control group physicians received no intervention. Physician management practice was measured by medical record audit, dietary counselling practice by patient telephone interview. Patient serum cholesterol levels were measured on three occasions: baseline, 6 weeks, and 6 months. Physician patient management scores on chart audit were similar across study groups. However, physician dietary counselling scores were significantly higher for both intervention groups than the control. Patient serum cholesterol levels were not significantly different across study groups. However, in the intervention groups, patients’ low-density lipoprotein levels decreased significantly overall from baseline to second follow-up, compared to increases in the control group. This intervention produced a change in physician dietary counselling associated with lowered patient low-density lipoprotein levels. Physician behavior change, leading to small changes in cardiovascular risk, may contribute to improved patient health outcomes.

Keywords: Cardiovascular risk; continuing medical education; physician behavior change; physician counselling practice
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