Barriers to detecting and treating hypercholesterolaemia in patients with ischaemic heart disease: primary care perceptions.

British Journal of General Practice

PubMedID: 16004739

Hickling J, Rogers S, Nazareth I. Barriers to detecting and treating hypercholesterolaemia in patients with ischaemic heart disease: primary care perceptions. Br J Gen Pract. 2005;55(516):534-8.
BACKGROUND
Treating hypercholesterolaemia in patients with ischaemic heart disease can significantly reduce vascular deaths and events. Many such patients, however, do not receive effective treatment for hypercholesterolaemia.

AIM
To ascertain the barriers to the detection and treatment of hypercholesterolaemia in patients with ischaemic heart disease as seen by primary care teams.

DESIGN OF STUDY
Qualitative study using the nominal group technique.

SETTING
General practice teams in the North Thames region of the Medical Research Council General Practice Research Framework.

METHOD
The main outcomes measures used were identification of the barriers to the detection and treatment of hypercholesterolaemia together with relative rankings.

RESULTS
Fourteen individual barriers were identified. The main barriers were: organisational barriers within general practices; confusing and conflicting guidelines from external sources; errors and omissions by GPs; communication problems at the interface between secondary and primary care; and reluctance by patients to take medication.

CONCLUSIONS
The reasons for suboptimal detection and treatment of hypercholesterolaemia are complex and act at various levels. Interventions to improve the management of this condition must address these barriers in order to be successful.