Cholesterol knowledge and practices among patients compared with physician management in a university primary care setting.

Lowering elevated serum cholesterol has been shown to reduce the risk of symptomatic coronary heart disease. The National Institute of Health and National Cholesterol Education Program recommend that all adults obtain a cholesterol screening and state that desirable adult levels are less than 200 mg/dl. This study examined the knowledge and practices regarding cholesterol among patients and physicians in a university-based primary care clinic that serves a large proportion of elderly and indigent patients. One hundred fifty-nine patients were interviewed and their medical records were examined. Twenty-four percent of patients were aware of their elevated cholesterol levels, 60% were aware of the health risks associated with hypercholesterolemia, and 83% were able to state methods of lowering cholesterol levels. Approximately 50% stated that they were making considerable efforts to lower fat and cholesterol consumption. Physicians listed cholesterol as a problem in 29% of patients with elevated values (greater than 200 mg/dl) and counseled 17%. Results indicate a good level of knowledge and interest in cholesterol as a health risk even in this group of patients with the multiple problems associated with low socioeconomic status. Knowledge of personal risk status, however, was poor. Physicians need to improve documentation, counseling, and monitoring of patients with elevated cholesterol levels. Long-term follow-up is needed to evaluate efficacy.