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Ethnicity/Race, Use of Pharmacotherapy, Scope of Physician-Ordered Cholesterol Screening, and Provision of Diet/Nutrition or Exercise Counseling during US Office-Based Visits by Patients with Hyperlipidemia

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Abstract

Background

Elevation of serum cholesterol, or hyperlipidemia, is recognized as one of the major modifiable risk factors in the development of atherosclerosis and cardiovascular disease. On a US population basis, there has been a downward trend in total- and LDL-cholesterol levels, and an increase in cholesterol screening. Nevertheless, previous research suggests that there remain racial/ethnic disparities in the access to and quality of care for hyperlipidemia.

Objective

The aim of this study was to examine the extent of racial/ethnic disparities in the provision of pharmacotherapy, cholesterol screening and diet/nutrition or exercise counseling during US office-based physician-patient encounters (visits) by patients with hyperlipidemia.

Methods

We examined data from the 2005 US National Ambulatory Medical Care Survey for office-based visits for hyperlipidemia for patients aged ≥20 years in terms of prescribing for hyperlipidemia, and the ordering/provision of cholesterol testing, diet/nutrition counseling, and exercise counseling.

Results

Use of pharmacotherapy for hyperlipidemia varied by ethnicity/race (χ2, p<0.05). Physician-ordered/provided cholesterol screening occurred in 44.2% of all office-based visits; 46.5% for Whites, 35.4% for Blacks, and 30.3% for Hispanics (χ2, p< 0.05). Diet/nutrition counseling was ordered/provided in 39.7% of office-based visits; 40.4% for Whites, 32.6% for Blacks, and 39.0% for Hispanics (χ2, p<0.05). Exercise counseling was ordered/provided in 32.1% of office-based visits; 32.7% for Whites, 27.2% for Blacks, and 30.6% for Hispanics (χ2, p<0.05).

Conclusion

These findings reveal a disparity in use of pharmacotherapy for hyperlipidemia, physicianordered/provided cholesterol screening, diet/nutrition counseling, and exercise counseling by ethnicity/race. Further research is required to discern, in greater detail, reasons for the observed differences reported, and to ensure equitable access to established standards of care.

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Acknowledgments

No funding was used in the preparation of this article. The authors declare no conflicts of interest that are relevant to the content of this article.

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Authors and Affiliations

  1. Department of Pharmacotherapy, College of Pharmacy, Washington State University, PO Box 1495, Spokane, WA, 99210, USA

    Megan N. Willson, Joshua J. Neumiller, David A. Sclar & Tracy L. Skaer

  2. Department of Health Policy and Administration, College of Pharmacy, Washington State University, Pullman, Washington, USA

    David A. Sclar, Linda M. Robison & Tracy L. Skaer

Authors
  1. Megan N. Willson
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  2. Joshua J. Neumiller
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  3. David A. Sclar
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Correspondence to Megan N. Willson.

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Willson, M.N., Neumiller, J.J., Sclar, D.A. et al. Ethnicity/Race, Use of Pharmacotherapy, Scope of Physician-Ordered Cholesterol Screening, and Provision of Diet/Nutrition or Exercise Counseling during US Office-Based Visits by Patients with Hyperlipidemia. Am J Cardiovasc Drugs 10, 105–108 (2010). https://doi.org/10.2165/11532820-000000000-00000

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