Dissertations and Theses @ UNI

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Open Access Thesis

Keywords

Cholesterol--Diagnosis; Coronary heart disease--United States--Prevention; Blood cholesterol--Treatment; Coronary heart disease--Prevention; United States;

Abstract

This study was designed to determine if there is a difference in physician and physician assistant compliance with the National Cholesterol Education Program guidelines based on patient age and sex. A subproblem was to investigate differences between actual practice and physician and physician assistant perceptions about their treatment practices. The study was planned in two sections including a (a) chart audit, and (b) physician survey. The chart audit investigated screening, recognition, and treatment practices of physicians and physician assistants at the Northeast Iowa Family Practice Center. The survey sought to find information on physician and physician assistant perceptions of treatment practices. Two hundred medical charts of female patients and 200 medical charts of male patients were randomly selected from those patients seen at the Family Practice Center between August 1, 1992 and September 30, 1992. Those charts with total cholesterol levels greater than or equal to 200 mg/dl were further analyzed for recognition and treatment of the problem. The questionnaire was completed by 20 physicians and physician assistants practicing at the clinic during March, 1993. Faculty physicians numbered five, resident physicians 13, and physician assistants two. They answered questions pertaining to their familiarity with the National Cholesterol Education Program guidelines as well as questions about when they would initiate treatment in middle-aged males and females. Results indicated that 296 charts had cholesterol measures taken between August 1, 1988 and September 30, 1992, yielding an overall screening rate of 7 4 % . Further analysis of screening rates between age groups demonstrated that screening was not independent of the age group of the patient (p < .0001). Those patients 29 to 39 years of age had a screening rate of 53.1 % compared to 90.5 % in those patients 65 years of age or older. Of those patients with cholesterol measures in their charts, 205 ( 69. 3 % ) had total cholesterol levels greater than or equal to 200 mg/ dl. Overall recognition rate was 63.4% with no significant difference between the age group or sex of the patient. Treatment rates were 94.6% overall. No significant difference in treatment rates were found between age group and sex of the patient. However, patients in the oldest age group had a higher usage of cholesterol lowering medication (54.8%) than patients in the youngest age group (12.5%) (p > .05). Data from the survey indicated no difference between when physicians would initiate dietary therapy or medication in males and females. Additional education may be indicated in that only 2 (10.5 % ) of the survey respondents considered themselves "very familiar" with the National Cholesterol Education Program guidelines.

Year of Submission

1993

Degree Name

Master of Arts

Department

School of Health, Physical Education, and Leisure Services

First Advisor

Forrest A. Dolgener

Second Advisor

Fred W. Kolkhorst

Third Advisor

Dennis Cryer

Comments

If you are the rightful copyright holder of this thesis and wish to have it removed from the Open Access Collection, please submit a request to scholarworks@uni.edu and include clear identification of the work, preferably with URL.

Date Original

1993

Object Description

1 PDF file (68 leaves)

Language

en

File Format

application/pdf

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