Zusammenfassung

Background Dyslipidemia is a major risk factor for cardiovascular disease. There is little documentation about dyslipidemia among patients attending public primary care clinics in Jamaica. This study reports on an intervention to improve the management of these patients. Methods 500 records of patients with chronic diseases from six randomly selected health centers were audited in 2012. An intervention comprising feedback from audit, staff training in motivational interviewing, a reminder stamp in patients’ records and patient education cards was conducted over 12 months at 3 intervention health centers. 250 patient charts were from 3 control health centers. All 500 patient records were re-audited one year later. Primary outcome was improved LDL control. Differences between intervention and control groups at baseline were tested using Pearson’s χ2 and student t tests. Within group differences at re-audit were tested using McNemar χ2 and paired t-tests. Differences in lipid control were assessed using mixed effects logistic regression. Multi-level mixed effects analysis of variance models assessed for differential changes in lipid levels from baseline to re-audit. Results At baseline 21.7% of intervention and 14.2% of control patients achieved LDL targets (p = 0.143). Patients had a mean of 2.8 clinic visits during the intervention year. At re-audit, LDL increased by 0.34 mmol/L in the intervention group (p < 0.001), and by 0.15 mmol/L among the controls (p = 0.19). Conclusions There was no improvement in LDL control at re-audit. The study however provided useful information about lipid control among primary care patients in Jamaica.