Knowledge and management of hypercholesterolaemia in the primary health care.

Abstract

Hypercholesterolaemia is one of the major risk factors associated with cardiovascular disease. The aim of the study was to investigate the knowledge and views of clients and health professionals (HPs) on the management of hypercholesterolaemia in a community setting. The study participants, consisting of two groups, 64 clients and 80 HPs, were conveniently sampled from all health centres (Hes) in Malta. Twenty-two male and forty-two female clients, attending Hes for cholesterol blood screening were interviewed, while a questionnaire was addressed to 32 general physicians and 48 nurses, all working in the treatment room of the Hes. The response rate was 70%. Quantitative demographic data collected was analysed using descriptive statistics and qualitative data was collected and analysed through content analysis. The findings indicated that the clients' knowledge of hypercholesterolaemia was not optimal with 42% (n= 27) unable to define cholesterol per se but the majority knew of the complications associated with it. On the other hand, HPs revealed a good knowledge of defining serum cholesterol, but 38% (n=21) of them lacked knowledge on the guidelines. Fifty-four percent of professionals stated that hypercholesterolaemia was a condition that could be controlled while 39% assumed it to be a disease (familial), and 7% did not know. Since hypercholesterolaemia shows no symptoms the HPs declared it to be one of the main reasons for patients' non-adherence/compliance to guidelines and treatment. Other reasons given were those of behaviour and perceptions of clients. The HPs expressed the need of being kept updated on the latest guidelines. This was also revealed from the clients' interviews. Data shows that patients are not fully aware of guidelines and want to be more informed. This indicated that they are not being effectively advised by professionals. The results highlighted a general need both by the clients and the HPs for continued information and education. Guidelines on therapeutic lifestyle changes needed for cholesterol management, mainly diet, exercise and adherence to medication have to continually be brought to the attention of the HPs and these will then be able to educate the patients. The identified need for a "Nurse-led lipid clinic" with the participation of a team composed of nurses, doctors and nutritionist, in the community, is another recommendation which will enhance the management of hypercholesterolaemia in the primary health setting..