Cholesterol-reduction intervention study (CRIS): a randomized trial to assess effectiveness and costs in clinical practice.
Arch Intern Med
; 156(7): 731-9, 1996 Apr 08.
Article
en En
| MEDLINE
| ID: mdl-8615705
BACKGROUND: The 1988 US National Cholesterol Education Program Expert Panel Report recommended initial treatment with niacin or bile acid sequestrants, followed by other agents if needed, to lower low-density lipoprotein cholesterol (LDL-C) levels in hypercholesterolemic patients who require drug therapy. It is unknown how the effectiveness and costs of such an approach ("stepped care") compare in typical clinical practice to those of initial therapy with lovastatin. PATIENTS AND METHODS: We randomly assigned 612 patients, aged 20 to 70 years, who met 1988 National Cholesterol Education Program guidelines for drug treatment of elevated LDL-C level and had not previously used cholesterol-lowering medication, to either a stepped-care regimen or initial therapy with lovastatin (both n=306). The study, conducted at Southern California Kaiser Permanente, was designed to approximate typical practice: provider compliance with treatment plans was encouraged but not enforced, and patients paid for medication as they customarily would. RESULTS: At 1 year, the decline in mean LDL-C level was significantly greater among patients assigned to initial treatment with lovastatin (22% vs 15% for stepped care; P<.001), as was the number who attained goal LDL-C level (
Asunto(s)
Buscar en Google
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Lovastatina
/
Hipercolesterolemia
/
Anticolesterolemiantes
/
Niacina
Tipo de estudio:
Clinical_trials
/
Evaluation_studies
/
Guideline
/
Health_economic_evaluation
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Arch Intern Med
Año:
1996
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos
Buscar en Google
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Lovastatina
/
Hipercolesterolemia
/
Anticolesterolemiantes
/
Niacina
Tipo de estudio:
Clinical_trials
/
Evaluation_studies
/
Guideline
/
Health_economic_evaluation
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Arch Intern Med
Año:
1996
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos