Association between physician counseling for hypercholesterolemia and patient dietary knowledge.

High blood cholesterol is a prime target for preventive intervention in the primary care setting; however, the current effectiveness of clinicians at educating their patients about appropriate dietary modification is questionable. This report examines the association between dietary knowledge and physician counseling among primary care patients with hypercholesterolemia. Subjects were 325 patients continuously enrolled in one of two group model HMO offices for two years following a screening cholesterol level above 200 mg/dL. One office had American Heart Association educational materials and training in its use; one offered usual care. A chart audit and telephone survey (response 59%) 18 months following the screening cholesterol assessed clinician counseling and cholesterol monitoring as well as patient knowledge (from 14-item survey), attitudes, and behavior. Multiple linear regression analysis revealed no association between patient knowledge and physician dietary counseling (P = .53). Only patient educational background (P = .03) and baseline dietary knowledge (P = .005) independently predicted subsequent dietary knowledge. When added to the model, self-reported dietary change was also independently associated with patient knowledge (P = .0003). Though public awareness of cholesterol as a risk factor for heart disease has dramatically increased in recent years, specific dietary knowledge is often lacking. This article questions the adequacy of current primary care dietary treatment efforts in this regard.