The effect of physician office visits on CHD risk factor modification as part of a worksite cholesterol screening program

Jean S. Wang, Elise C. Carson, Kate L. Lapane, Charles B. Eaton, Kim M. Gans, Thomas M. Lasater

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background. Elevated serum cholesterol is a major risk factor for CHD. Primary prevention through behavioral modification has been designated first- line treatment for patients with elevated cholesterol. In this study, we assessed the impact of a physician office visit after a worksite cholesterol screening on self-reported changes in diet, weight loss, exercise, and smoking. We hypothesized that those individuals who had a physician office visit regarding cholesterol would make more changes in CHD risk factors than those who did not have such a visit. Methods. A cohort of 4,928 participants from 33 worksites in Massachusetts and Rhode Island had baseline CHD risk factors evaluated at a cholesterol screening and 4,473 were available at follow-up 6 months later by telephone interview. A total of 1,957 had elevated cholesterol levels (≥200 mg/dl) and were instructed to visit their physician, in addition to receiving educational materials related to CHD risk factor modification. Results. Most individuals with elevated cholesterol levels had other prevalent self-reported CHD risk factors at baseline: 58% consumed high-fat diets (>30% fat), 43% were overweight, 60% had a sedentary lifestyle (sweat-related physical activity <3 x per week), and 22% were cigarette smokers. After 6 months of followup, 74% of participants with high- fat diets reported eating a lower fat diet, 71% of overweight participants reported weight loss, 53% of sedentary participants attempted to increase physical activity, and 38% of smokers decreased or quit cigarette smoking. Thirty-five percent of participants completed the referral for a physician office visit to discuss their elevated cholesterol determined at the baseline worksite screening. However, these individuals showed only a modest change (which was not statistically significant) in self-reported CHD risk factors compared with those who did not have follow-up physician visits after adjusting for age, sex, race, education, occupation, medical insurance, time since last doctor visit, diabetes, and hypertension. Objective measurements of serum cholesterol, body mass index, and dietary score were likewise modestly improved and not statistically significant. Conclusions. In 6 months of follow-up, high absolute levels of CHD risk factor modification were observed after a worksite cholesterol screening. A physician office visit added only a modest but not statistically significant benefit for further CHD risk factor modification. These findings indicate that the follow-up cholesterol-related physician visit had little added clinical benefit over the screening intervention alone.

Original languageEnglish (US)
Pages (from-to)221-228
Number of pages8
JournalPreventive Medicine
Volume28
Issue number3
DOIs
StatePublished - Mar 1999

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Keywords

  • Adult
  • Atherosclerosis
  • Blood
  • Cholesterol
  • Diet
  • Female
  • Follow-up studies
  • Health status
  • Human
  • Hypercholesterolemia/blood/epidemiology/prevention and control
  • Lifestyle
  • Male
  • Mass screening
  • Physician's practice patterns
  • Prevention and control
  • Questionnaires
  • Referral and consultation
  • Risk factors

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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