Key result
Physicians fail to treat hypercholesterolaemia in ~39% of CCU patients post-discharge.
Why the study?
Physician responses to hypercholesterolaemia detected during CCU admission were not well characterized.
What is the physician response to screening for hypercholesterolaemia in patients admitted to a coronary care unit?
Observational (n=176)
No
What is the physician response to screening for hypercholesterolaemia in patients admitted to a coronary care unit?
A significant proportion of patients (39%) with hypercholesterolaemia admitted to a CCU received no follow-up action or treatment for their elevated lipids, highlighting a gap in secondary prevention.
Answers are grounded in this paper and cite their sources.
Suboptimal responses to hypercholesterolaemia in CCU patients may undermine secondary prevention; leaves open whether implementation strategies improve uptake.
Hypercholesterolaemia is a known risk factor for coronary artery disease. This study describes a retrospective analysis of 176 patients admitted to the Coronary Care Unit (CCU) in a six month period with an admission fasting serum cholesterol of greater than 5.5 millimoles per litre (mmols/L). The patient records were examined at least six months after hospital discharge to determine what action, if any, was instituted in response to their hypercholesterolaemia. One hundred and thirty-four (76%) patients had a discharge diagnosis of myocardial ischaemia or infarction. Of the 176 patients, 73 were referred to a dietitian, 31 were given dietary advice by a medical officer, 13 were commenced on lipid-lowering drugs with nine continuing lipid-lowering drugs and only 13 patients were referred to this hospital's lipid clinic. Sixty-nine (39%) received no response to their hypercholesterolaemia. It is likely that our experience is not unique and greater attention to CCU measured lipid results and risk factor modification should be instituted by physicians.
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Cox et al. (1991) conducted an observational in Hypercholesterolaemia (n=176). Physician response to hypercholesterolaemia was evaluated on Action instituted in response to hypercholesterolaemia. Among 176 CCU patients with hypercholesterolaemia, 69 (39%) received no physician response or intervention for their elevated cholesterol at least six months post-discharge.
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