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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.