Physician and patient barriers to adherence with cholesterol guidelines

Several national studies have shown poor compliance with National Cholesterol Education Program II (NCEP) goals. A study we conducted of patients in the General Internal Medicine Clinic at the Marshall University Joan C. Edwards School of Medicine in Huntington showed that 46% of them were not at NCEP goals. We hypothesized that both patient and physician barriers were responsible for these findings so we administered two surveys about barriers to cholesterol management to 261 random patients identified with hypercholesterolemia and to all 50 residents and faculty at the clinic. We identified insufficient knowledge of low cholesterol foods as a patient barrier (31.6% of patients), and inadequate time to review NCEP guidelines as a physician barrier (45.5% of physicians). We conclude that many patients in our practice lack the knowledge of what foods are low in cholesterol and that our physicians may not use the NCEP guidelines because they are inconvenient to access in our clinic. Future research should explore ways to improve patient knowledge of low cholesterol foods and accessibility of guidelines for use during patient visits.