J Engerman | PubMed Health

PubMed1991

The impact of office cholesterol testing.

BACKGROUND: The role of portable cholesterol analyzers in the identification and management of hypercholesterolemia is controversial. This study investigated the effect of free office cholesterol testing on screening behavior and on blood cholesterol reduction in a family practice center. METHODS: After a baseline period of 5 months, an office cholesterol analyzer was made available for 1 year to two teams of patients and providers (study group), but not to the other two teams (control group). RESULTS: The percentage of patients screened increased from 28% to 52% in the study group, and from 29% to 42% in the control group (difference favoring study group, prevalence odds ratio = 1.47, 95% confidence interval [CI] = 1.33 to 1.62). Compared with those whose cholesterol tests were sent to outside laboratories, patients screened with the office analyzer were younger (mean age 36 years vs 42 years), and the barrier to those without insurance was reduced. There was no clinically or statistically significant effect on lowering cholesterol (difference favoring study group = 0.01 mmol/L, 95% CI = -0.15 to 0.17). CONCLUSIONS: The availability of free office cholesterol testing increased the prevalence of cholesterol testing, particularly for younger patients and those without insurance; however, the testing had no discernible effect of motivating patients to lower their blood cholesterol levels.

Adult↗

PubMed1991

Barriers to cholesterol testing in a rural community.

BACKGROUND: The purpose of this study was to investigate the factors that determine whether residents in a rural community have their cholesterol tested. METHODS: A population-based survey was conducted in 1987 as part of a community-oriented primary care project that sought to define and address the causes of and burden caused by increased cardiovascular disease in an economically depressed agricultural region of New York. All of the residents living in two towns in the region who were over 16 years of age and who lived in their homes year-round were surveyed. Demographic information was obtained from the participants, as well as information about previous cholesterol testing and their cardiovascular-risk knowledge and behaviors. The serum cholesterol of each participant was measured. RESULTS: Of the 557 households contacted, 508 (91%) households participated. A total of 1063 persons over 16 years of age were surveyed, and 973 (92%) were screened for cholesterol. Overall, 24% reported prior cholesterol testing. Logistic regression analysis identified several independent factors that were associated with a reduced likelihood of ever having had a cholesterol test. These factors included: (1) age under 45 years, (2) having less than 12 years of education, (3) having an income of less than $10,000, (4) not having health insurance, (5) not having visited a physician within the previous year, and (6) practicing three or more high-risk cardiovascular behaviors. The participants' cardiovascular knowledge made no independent contribution to having had their cholesterol levels tested. CONCLUSIONS: Many of the factors that prevent cholesterol testing are socially determined. The results of this study suggest that financial and social barriers are two of the major obstacles to residents of rural communities having their cholesterol levels tested.

Adolescent↗