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The plethora
of available guidelines which have focused on the relative risk of specific
risk factors rather than on absolute risk of CHD given the presence of
several risk factors in an individual patient cause confusion in
understanding especially those with very minimal back ground of public
health, research & Epidemiology. The physician and patient may feel
overwhelmed as to how to prioritize risk factor reduction in a realistic and
cost-effective manner. Health care providers need to understand and be able
to communicate what the anticipated absolute benefit of a given risk-factor
reduction strategy is in a specific patient. The
other major knowledge deficit for most providers is in techniques for
enhancing adherence to medication and lifestyle changes. Although 95% of
medical schools currently instruct students in communication skills, these
skills are rarely reinforced in postgraduate training and continuing medical
education programs. There is a large body of evidence of the effective
health counseling techniques. And most physicians lack confidence in their
ability to enhance their patients' adherence to medication and
behavior-change regimens. |
