DYSLIPIDEMIA MONITORING SYSTEM

ELEVATED SERUM CHOLESTEROL (DYSLIPIDEMIA) IS COMMON AND IS AMAJOR RISK FACTOR FOR CARDIOVASCULAR DISEASE. THE DYSLIPIDEMIA MONITORING SYSTEM (DMS), DEVELOPED IN THIS PROJECT, IS A COMPUTER-BASED TELECOMMUNICATIONS SYSTEM THAT ASSISTS PHYSICIANS IN MANAGING AMBULATORY DYSLIPIDEMIA PATIENTS BY TRACKING THEM BETWEEN OFFICE VISITS BY WEEKLY TELEPHONE CONVERSATIONS WITH PATIENTS IN THEIR HOMES. THE DMS USES COMPUTER-CONTROLLED SPEECH SYNTHESIS TO SPEAK. THE PATIENTS COMMUNICATE BY DEPRESSING KEYS ON A TOUCH-TONE TELEPHONE. THE DMS COSTS $12 PER PATIENT YEAR. IT ASKS PATIENTS TO REPORT THEIR CURRENT WEIGHT, DIETARY INTAKE, EXERCISE, MEDICATION-TAKING KNOWLEDGE AND COMPLIANCE, AND ANY SYMPTOMS SUGGESTING SIDE EFFECTS. THE DMS RESPONDS TO THE ANSWERS OF PATIENTS BY GIVING FEEDBACK TO MOTIVATE THEM TO ADHERE TO LOW FAT AND CHOLESTEROL DIETS, TO ENGAGE IN REGULAR EXERCISE, AND TO TAKE ANY PRESCRIBED LIPID-LOWERING MEDICATIONS COMPLETELY. THE SYSTEM STORES AND TRANSMITS INFORMATION REPORTED BY THE PATIENT TO THE PHYSICIAN ON A PRINTED REPORT, ALERTING THE PHYSICIAN TO ANY POTENTIAL PROBLEMS. THE DMS WILL BE (1) PILOT TESTED WITH 15 PATIENTS AND 92) EVALUATED IN A RANDOMIZED CONTROLLED CLINICAL TRIAL OF 135 PATIENTS SEEN IN A GENERAL INTERNAL MEDICINE PRACTICE. THE ENDPOINTS WILL BE THE CHANGES IN PATIENTS' SELF-CARE BEHAVIORS (EXERCISE, DIET, AND MEDICATION TAKING) AND SERUM LIPID LEVELS. THE USABILITY AND ACCEPTABILITY TO PATIENT AND PHYSICIAN USERS WILL BE MEASURED BY ATTITUDINAL QUESTIONNAIRES, AND THE OPERATING COSTS WILL BE CALCULATED.