Detection and treatment of hypercholesterolemia in primary health care. Results of the POLKARD program of the Ministry of Health of the Republic of Poland

Abstract

Introduction: About 90% of Polish adults with hypercholesterolemia are not aware of their disease or are not treated.

Objectives: The aim of the study was to evaluate hypercholesterolemia control in general practice and to assess the implications of introducing the nationwide Program of Cardiovascular Disease Prevention (PCVDP).

Patients and methods: Sixty-six primary care clinics were scheduled to participate in the study. In half of them, PCVDP was implemented (active clinics), the remaining 33 constituted the control group. Study participants were selected from a group of persons aged 35-55 years with medical records established before January 1, 2005. Patients with coronary heart disease, stroke, or peripheral atherosclerosis were excluded. In a random sample of patients scheduled for the study, medical records were reviewed followed by an interview, physical examination, and blood lipid tests.

Results: The availability of data on total cholesterol (TC) levels increased from 19.2% to 40.5% in patients from the active clinics and did not change in the control group. Hypercholesterolemia treatment was reported more often in the active clinics than in the control group (4.4% and 3.3%, respectively, P <0.01). Patients from the active clinics more often reported that a physician informed them about increased TC levels compared with the control group (29.1% and 24.1%, respectively, P <0.01). However, the percentage of patients with increased TC or low-density lipoprotein cholesterol levels and those using statins did not differ between the study groups.

Conclusions: PCVDP is an effective tool to identify subjects with hypercholesterolemia but has no effect on the rate of achieving the recommended treatment targets.