An intervention to increase physicians' use of adherence-enhancing strategies in managing hypercholesterolemic patients

An intervention to increase physicians' use of adherence-enhancing strategies in managing hypercholesterolemic patients

Patients' lack of adherence to medical regimens frustrates many practicing physicians. This study was conducted to determine the effectiveness of a combined continuing medical education intervention in increasing physicians' adherence-enhancing skills and improving hypercholesterolemic pat...

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Bibliographic Details
Published in:Academic medicine Vol. 74; no. 12; p. 1334
Main Authors: Casebeer, L L, Klapow, J C, Centor, R M, Stafford, M A, Renkl, L A, Mallinger, A P, Kristofco, R E
Format: Journal Article
Language:English
Published: United States 01-12-1999
Subjects:
Adult
Alabama
Analysis of Variance
Clinical Competence
Cohort Studies
Comorbidity
Education, Medical, Continuing
Female
Humans
Hypercholesterolemia - therapy
Male
Middle Aged
Patient Compliance
Prospective Studies
Statistics, Nonparametric
Alabama
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Summary:Patients' lack of adherence to medical regimens frustrates many practicing physicians. This study was conducted to determine the effectiveness of a combined continuing medical education intervention in increasing physicians' adherence-enhancing skills and improving hypercholesterolemic patients' health. A prospective, randomized, controlled trial was designed using a nested cohort of 28 community physicians throughout Alabama and 222 of their hypercholesterolemic outpatients. The intervention, carried out in 1998, consisted of three interactive case audio-conferences plus chart reminders. Physicians' learning was measured by unannounced standardized patients, and patients' health by serum cholesterol levels, weight, knowledge of hypercholesterolemia, self-reported dietary habits, and health status. No significant difference was found in the numbers of physician adherence-enhancing strategies, although the number did increase within the treatment group. There were significant differences in the intervention group's patients' knowledge of cholesterol management (p = .008) and significant reductions in their self-reported consumption of dietary fats (p = .002). A significant difference was found in the serum cholesterol level of men in the intervention group nine months after the intervention (p = .02). Combining a series of interactive case audio-conferences with chart reminders shows promise in increasing physicians' adherence-enhancing strategies. In chronic disease management, the problem of enhancing adherence remains complex.
ISSN:1040-2446
DOI:10.1097/00001888-199912000-00018