Document Detail


Ethnicity/race, use of pharmacotherapy, scope of physician-ordered cholesterol screening, and provision of diet/nutrition or exercise counseling during US office-based visits by patients with hyperlipidemia.
MedLine Citation:
PMID:  20334447     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Elevation of serum cholesterol, or hyperlipidemia, is recognized as one of the major modifiable risk factors in the development of atherosclerosis and cardiovascular disease. On a US population basis, there has been a downward trend in total- and LDL-cholesterol levels, and an increase in cholesterol screening. Nevertheless, previous research suggests that there remain racial/ethnic disparities in the access to and quality of care for hyperlipidemia. OBJECTIVE: The aim of this study was to examine the extent of racial/ethnic disparities in the provision of pharmacotherapy, cholesterol screening and diet/nutrition or exercise counseling during US office-based physician-patient encounters (visits) by patients with hyperlipidemia. METHODS: We examined data from the 2005 US National Ambulatory Medical Care Survey for office-based visits for hyperlipidemia for patients aged > or =20 years in terms of prescribing for hyperlipidemia, and the ordering/provision of cholesterol testing, diet/nutrition counseling, and exercise counseling. RESULTS: Use of pharmacotherapy for hyperlipidemia varied by ethnicity/race (chi2, p < 0.05). Physician-ordered/provided cholesterol screening occurred in 44.2% of all office-based visits; 46.5% for Whites, 35.4% for Blacks, and 30.3% for Hispanics (chi2, p < 0.05). Diet/nutrition counseling was ordered/provided in 39.7% of office-based visits; 40.4% for Whites, 32.6% for Blacks, and 39.0% for Hispanics (chi2, p < 0.05). Exercise counseling was ordered/provided in 32.1% of office-based visits; 32.7% for Whites, 27.2% for Blacks, and 30.6% for Hispanics (chi2, p < 0.05). CONCLUSIONS: These findings reveal a disparity in use of pharmacotherapy for hyperlipidemia, physician-ordered/provided cholesterol screening, diet/nutrition counseling, and exercise counseling by ethnicity/race. Further research is required to discern, in greater detail, reasons for the observed differences reported, and to ensure equitable access to established standards of care.
Authors:
Megan N Willson; Joshua J Neumiller; David A Sclar; Linda M Robison; Tracy L Skaer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of cardiovascular drugs : drugs, devices, and other interventions     Volume:  10     ISSN:  1175-3277     ISO Abbreviation:  Am J Cardiovasc Drugs     Publication Date:  2010  
Date Detail:
Created Date:  2010-03-25     Completed Date:  2010-06-08     Revised Date:  2010-09-16    
Medline Journal Info:
Nlm Unique ID:  100967755     Medline TA:  Am J Cardiovasc Drugs     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  105-8     Citation Subset:  IM    
Affiliation:
Department of Pharmacotherapy, College of Pharmacy, Washington State University, Spokane, Washington, USA. mwillson@wsu.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
African Americans / statistics & numerical data
Aged
Cholesterol / blood
Directive Counseling / standards,  statistics & numerical data*
European Continental Ancestry Group / statistics & numerical data
Exercise Therapy
Female
Health Care Surveys
Health Services Accessibility / statistics & numerical data
Healthcare Disparities / statistics & numerical data*
Hispanic Americans / statistics & numerical data
Humans
Hyperlipidemias / therapy*
Male
Mass Screening / methods
Middle Aged
Office Visits / statistics & numerical data
Physician's Practice Patterns / standards,  statistics & numerical data*
United States / epidemiology
Young Adult
Chemical
Reg. No./Substance:
57-88-5/Cholesterol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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