Are patients with hyperlipidemia being treated? Investigation of cholesterol treatment practices in an HMO primary care setting

Background. The main study objective was to investigate cholesterol treatme nt practices of primary care physicians in a managed care setting. Methods. The study was a retrospective review of data with a quasiexperimen tal design. The National Cholesterol Education Program-Adult Treatment Pane l II (NCEP-ATP II) guidelines were used as the reference for conducting a m easurement model in the study. Data were randomly selected via a systematic probability sampling method from a health maintenance organization (HMO) c apitated risk-based contracting medical clinic in southern Florida. Results. Of the 348 patients selected for the study, 224 (65%) needed eithe r dietary therapy (n = 106) or drug therapy (n = 118). However, only 16 pat ients (13.6%) had ever had cholesterol-lowering drug regimens prescribed du ring the 5-year study period. Conclusions. Our findings indicate that (1) primary care physicians have po orly adopted the cholesterol management practice recommended by NCEP guidel ines and need to improve their recognition and treatment of hypercholestero lemia; and (2) the problem of underutilizing prescription medications may b e associated with risk-sharing capitation arrangements between physicians a nd third-party insurers.