Department of Pathology and Laboratory Medicine and Calgary Laboratory Services, University of Calgary, Calgary, Alberta, Canada.
Chinook Primary Care Network, Lethbridge, Alberta, Canada.
Can J Cardiol. 2017 May;33(5):682-684. doi: 10.1016/j.cjca.2017.02.005. Epub 2017 Feb 20.
Low rates of cardiovascular preventive therapy with statin medications is a significant public health problem in Canada. There is a pressing need for public health interventions to increase the use of statin medications, especially among high-risk patients. In this article, we present the results of a quality assurance pilot program to provide laboratory-reported Framingham Risk Score (FRS) to physicians. This work was performed in a mixed urban and rural setting in southern Alberta. We provided FRSs and, for high-risk patients, statin treatment recommendations in conjunction with laboratory lipid panel requests. Adhesive labels were supplied to primary care physicians, and space was provided for information necessary for the calculation of the FRS by a laboratory information system. In total, 16 physicians from 4 different clinics participated in the pilot program. Data were collected from October 25, 2014-November 5, 2015, during which time 1266 patients had FRSs from the laboratory. Three hundred twenty-four individuals were identified as high risk for coronary heart disease (≥ 20% 10-year risk) and received a recommendation for treatment with a statin medication in the laboratory result report. These individuals had a 26% relative and a 6.4% absolute increase in statin prescriptions compared with before the pilot program. The laboratory-based provision of FRSs with statin treatment recommendations for high-risk individuals has the potential to significantly increase the use of statin drugs.
在加拿大，他汀类药物等心血管预防治疗的使用率较低，是一个严重的公共卫生问题。迫切需要采取公共卫生干预措施来提高他汀类药物的使用，尤其是针对高危患者。在本文中，我们介绍了一个质量保证试点计划的结果，该计划旨在向医生提供实验室报告的弗雷明汉风险评分（FRS）。这项工作是在艾伯塔省南部的一个混合城乡环境中进行的。我们提供了 FRS，并结合实验室血脂面板请求，为高危患者提供了他汀类药物治疗建议。我们向初级保健医生提供了粘性标签，并为实验室信息系统计算 FRS 所需的信息留出了空间。共有来自 4 个不同诊所的 16 名医生参加了试点计划。数据收集时间为 2014 年 10 月 25 日至 2015 年 11 月 5 日，在此期间，实验室共为 1266 名患者提供了 FRS。有 324 人被确定为冠心病高危人群（≥20%的 10 年风险），并在实验室结果报告中收到了使用他汀类药物治疗的建议。与试点计划之前相比，这些患者的他汀类药物处方相对增加了 26%，绝对增加了 6.4%。通过实验室提供 FRS 和针对高危人群的他汀类药物治疗建议，有可能显著增加他汀类药物的使用。
