Response of patients and physicians to mass screening for coronary risk factors.

Qestionnaires were sent to 1,817 adults screened twice for coronary risk factors 10 to 11 months apart and to their physicians. Physician questionnaires returned on 1,764 persons indicated that 359 (20.4%) of the total group and 227 of 1,191 persons (19.1%) with one or more abnormal risk factors during the first screen did not return for follow-up care. Only persons with one or more risk factors were given advice or medication. When the 227 patients that did not return for follow-up are removed from the group with one or more risk factors, the 239 patients who received advice or treatment comprise 24.8% of those who could have been treated. Of the total 1,764 patients, 13.5% recieved treatment or advice. Qestionnaires returned by 1,396 persons who received follow-up care by their physicians confirmed that only those who had one or more risk factors received advice or treatment. Results of the patient questionnaires show that 223 persons received advice or treatment (23.2% of all with risk factors who returned for follow-up; 16.0% of the 1,396 persons). Furthermore, of 116 persons prescribed medication for risk factor control, 60 (51.7%) were not taking this medication. Of 20, persons given advice for reduction of risk factors, 162 (78.9%) were not following this advice. These data indicate physician indifference and patient apathy to reduction of coronary risk factors in asymptomatic individuals.