Hyperlipidaemia in general practice: three year follow up of an opportunistic screening project.
Mann JI., Morgan B., Ball M., Mant D., Jones L., Robertson I.
As part of the national lipid screening project 927 people with a plasma cholesterol level greater than 6.5 mM were detected by screening 4006 men and women aged 25-59 years. Three years later 801 of the 878 patients eligible for a follow-up study (91%) had been followed up at least once. The median number of follow-up visits was two. The bulk of the workload fell on the nursing staff. The mean decrease in cholesterol level was 8-14% in those receiving dietary advice only, 15-25% in those receiving additional drug treatment and 12% for all patients. A proportion of this decrease must be attributable to regression to the mean, loss to follow up when patients were doing well, and the patients' knowledge of their follow-up date. Data on a group of patients not attending for regular follow up suggest that regression to the mean could account for up to 7% of the cholesterol reduction observed. Screening for hyperlipidaemia in general practice is feasible when the necessary infrastructure is provided, but even with a fairly conservative protocol 3% of those screened received drug treatment.