The primary goal of this project is to test the efficacy of a program for teaching physicians how they can more effectively treat patients with elevated blood cholesterol. Educating and encouraging physicians to properly counsel their patients in the reduction of dietary saturated fats and cholesterol is the major focus. They will also be taught to use medications for patients in the highest risk category and for those who are unable to lower their cholesterol by diet alone. Physicians will be randomly assigned to one of four educational groups or a control group. The educational groups' formats include: three face-to-face seminars, one seminar, three telephone conference calls and one telephone conference call. It is expected that (1) the educated groups will be more effective in teaching physicians to lower cholesterol levels of their patients than the control group (2) seminars will be more effective than conference calls and (3) three educational sessions (seminar or conference call) will be more effective than one session. This proposal is the continuation of a three-year controlled education al trial at UCSF using the Professional Competence Assurance Program (PROCAP) to improve treatment of hypertension. This trial uses a behavioral counseling approach which focuses on both dietary counseling and encouragement of patients' compliance with medications. PROCAP has been developing innovative programs over the past 10 years, which promote change in physician performance and patient outcome through an individualized CME approach. The basic components use medical record review and patient surveys. These data comprise the feedback report comparing the individual physician's performance to that of peers. A syllabus is developed reflecting current scientific knowledge, national standards, the behavioral counseling model and areas found to be deficient in the record and survey. The telephone conference call among three to four participants and a faculty expert elaborates on the educational materials and addresses individual problems. The program will build upon the experience of PROCAP in hypertension and the successful national campaign to control hypertension through publication of standards of care and widespread professional education. Of major significance will be the development of educational materials in concert with the NHLBI and the evaluation of their efforts in professional and public education concerning cholesterol.
