Results from a practice-based lipid clinic model in achieving low density lipoprotein cholesterol goals.
OBJECTIVE: Lipid clinic models that combine diet and drug therapy have shown significantly better hyperlipidemia management than usual care. The objective is to demonstrate that such a model can be established and utilized in a primary care practice, replicating the results obtained in specialty clinic settings. DESIGN: This study evaluated a "lipid clinic" model for cholesterol management in a primary care setting. SETTING/PARTICIPANTS: Men and women for both the study and control groups were selected from those with abnormal lipid profiles determined during the course of routine healthcare in community internal medicine group practices. INTERVENTION: Control subjects are those selected by chart review from the practices of four general internists. These physicians treated their patients according to "usual practice". Study subjects are those from another general internal medicine practice who volunteered to enroll in that practice-based "lipid clinic". MEASUREMENT & RESULTS: This program demonstrated significant reductions in total and low density lipoprotein cholesterol in patients with coronary heart disease, diabetes mellitus, and patients without coronary heart disease defined as high and low risk. It used a specialty clinic-based intervention that included diet, medication, and follow-up by nurses and physicians. Almost 90% of all patients were on appropriate drug therapy and achieved therapeutic goals. CONCLUSION: We believe that a primary care practice-based, lipid clinic model employing physician involvement, diet, maximal drug therapy and patient tracking can result in superior achievement of treatment goals.
Thomas, HD; Maynard, C; Wagner, GS; Eisenstein, EL
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