Dissemination and implementation of guidelines for lipid lowering

Lipid lowering practice as reported by family physicians is described and related to current guidelines. During autumn 1989, a random physician sample was invited to a telephone interview, and 187 (93%) participated; they were asked about their awareness of consensus statements about hyperlipidaemia and their present practice habits in the diagnosis and treatment of hyperlipidaemia. Most commonly named sources of information were continuing medical education, consensus reports, professional journals and commercial sources. Most commonly used reference literature was consensus reports. The mean upper limit for desirable cholesterol in a 48-year old man was given as 6.2 mmol/l (recommended 5.2 mmol/l); non-pharmacological treatment was considered at 6.4 mmol/l (recommended 6.5) and pharmacological treatment at 8.0 (recommended 7.9). Exact consensus values were known by a minority of the physicians. Three-quarters of the physicians could name a first choice lipid lowering drug and half had a second choice. With the exception that those aware of a consensus report gave a significantly lower cut off point for pharmacological treatment (p = 0.043), there was no relationship between practice habits and source of information. Those stating consensus guidelines as their prime reference also gave a significantly lower cut-off point for non-pharmacological treatment (p = 0.036). We conclude that to influence medical practice, guidelines need extensive support from educational activities and quality assurance.