PHYSICIAN MANAGEMENT OF HYPERCHOLESTEROLEMIA - A RANDOMIZED TRIAL OF CONTINUING MEDICAL-EDUCATION

To determine the effect of continuing medical education (CME) on compl iance with the recommendations of the National Cholesterol Education P rogram Expert Panel on high serum cholesterol levels in adults, we ran domly assigned primary care physicians in 174 practices to 3 groups, 2 that underwent either standard or intensive CME and a control group. The standard CME group was offered a free 3-hour seminar on high serum cholesterol levels; the intensive CME group was offered in addition f ollow-up seminars and free office materials. After 18 months, we audit ed 13,099 medical records from the 140 practices that remained in the study. There were no significant differences (P>.15) in screening for high serum cholesterol or compliance with guidelines between the group s receiving continuing medical education (51% screening; 33% complianc e) and the control group (57% screening; 37% compliance). In the presp ecified subgroup of patients with hypercholesterolemia, there was a tr end toward a modest benefit from the continuing medical education inte rventions: compliance was 21% in the control group, 23% in the standar d CME group, and 27% in the intensive CME group (P = .07 overall). The se results emphasize the need for better ways to change behavior in pr acticing physicians and the importance of studying the implementation of preventive health recommendations.