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What factors determine whether individuals found to have hypercholesterolaemia at mass screening accept advice to
R Guibert1, N Leduc, P Fournier
1Department of Family Medicine, McGill University, Canada.
Insights
High cholesterol patients
Area of Science:
- Cardiovascular disease risk factor management
- Health behavior and promotion
Background:
- Mass screenings identify individuals with elevated cholesterol (> 6.2 mmol/l).
- Adherence to physician recommendations is crucial for managing hypercholesterolemia and preventing cardiovascular diseases.
Purpose of the Study:
- To identify factors influencing patient compliance with physician visit recommendations after hypercholesterolemia detection.
- To evaluate the applicability of the Health Belief Model in understanding adherence to medical advice.
Main Methods:
- A phone survey assessed 1144 hypercholesterolemic adults using the Health Belief Model constructs (perceived seriousness, self-efficacy, cues to action).
- Multivariate analyses examined determinants of compliance with physician visit recommendations.
- Data collected from 54 worksites and 29 public areas.
Main Results:
- Overall compliance was 58.6%.
- Perceived seriousness (personal history of cardiovascular disease/risk factors, prior awareness) and cues to action (higher cholesterol, hypertension) increased compliance.
- Smokers and those unaware of their condition showed lower compliance. Perceived self-efficacy positively influenced adherence.
- Compliance significantly increased with age.
Conclusions:
- The Health Belief Model effectively explains compliance with physician recommendations post-screening.
- Interventions should consider perceived seriousness, self-efficacy, and specific cues to action to improve adherence in hypercholesterolemic individuals.
Objective:
This study aims to identify the determinants of compliance with the recommendation to visit a physician for advice which was given to individuals whose cholesterolemia was > 6.2 mmol/l at mass screening for risk factors of cardiovascular diseases.
Methods:
Data were collected from 1144 adults found to be hypercholesterolemic during a screening programme in 54 work sites and 29 public areas and contacted by phone two to six months later. Based on the Health Belief Model, perceived seriousness, perceived self-efficacy, and cues to action were measured. Potential determinants of compliance to the recommendation were examined using multivariate analyses.
Results:
Mean compliance was 58.6%. For the perceived seriousness dimension of the Health Belief Model, personal history of CVD or risk factors, and prior awareness of cholesterol levels were important determinants. Those already treated for hypercholesterolemia comply twice as much as those who were aware and untreated. Among cues to action, higher cholesterol levels and hypertension are associated with greater compliance; however, smokers were less likely to comply. The dimension of perceived self-efficacy, as measured by ease of access to health services and prior success in eating habit modification, is also associated with compliance to the recommendation. Compliance increases significantly with age. For those previously aware of their elevated cholesterol level, variables representing perceived self-efficacy were no longer determinants. For those previously unaware of their elevated cholesterol level, variables representing CVD perceived threat do not influence compliance.
Conclusion:
The Health Belief Model appears to be an appropriate framework to the determinants of compliance with the recommendation to visit a doctor during mass screening.