Lai

Abstract

Background. The main study objective was to investigate cholesterol treatment practices of primary care physicians in a managed care setting. Methods. The study was a retrospective review of data with a quasiexperimental design. The National Cholesterol Education Program–Adult Treatment Panel II (NCEP-ATP II) guidelines were used as the reference for conducting a measurement model in the study. Data were randomly selected via a systematic probability sampling method from a health maintenance organization (HMO) capitated risk-based contracting medical clinic in southern Florida. Results. Of the 348 patients selected for the study, 224 (65%) needed either dietary therapy (n = 106) or drug therapy (n =118). However, only 16 patients (13.6%) had ever had cholesterol-lowering drug regimens prescribed during the 5-year study period. Conclusions. Our findings indicate that (1) primary care physicians have poorly adopted the cholesterol management practice recommended by NCEP guidelines and need to improve their recognition and treatment of hypercholesterolemia; and (2) the problem of underutilizing prescription medications may be associated with risk-sharing capitation arrangements between physicians and third-party insurers. From the Department of Pharmacy Administration, Nova Southeastern University, Fort Lauderdale, Fla. Reprint requests to L. Leanne Lai, PhD, Nova Southeastern University, Department of Pharmacy Administration, 3200 S University Dr, Fort Lauderdale, FL 33328. Lai et al • TREATMENT OF HYPERLIPIDEMIA IN AN HMO 283 284 March 2000 • SOUTHERN MEDICAL JOURNAL • Vol. 93, No. 3 care physicians’ clinical judgments and practices in treating hypercholesterolemia, with emphasis on the HMO managed care setting.