Garza Litzie, Dols Jean, Gillespie Maria
Ila Faye Miller School of Nursing, University of the Incarnate Word, San Antonio, Texas.
J Am Assoc Nurse Pract. 2017 Oct;29(10):606-611. doi: 10.1002/2327-6924.12492. Epub 2017 Aug 3.
This project was designed to increase family practice clinicians' adherence to the American College of Cardiology/American Heart Association (2013) and American Diabetes Association (ADA, 2016) clinical practice guidelines for the prevention of cardiovascular disease (CVD) in 40- to 75-year-old adults with type II diabetes (DMII) through interactive education, an electronic alert, and quality improvement sessions on the treatment and management of cholesterol in a family practice primary care setting.
A pre- and postretrospective chart review of 159 charts from a family practice clinic was conducted. Included in the chart review were 40- to 75-year-olds with a diagnosis of DMII.
Three outcomes were analyzed. Assessment of Atherosclerotic Cardiovascular Disease risk score increased from 0% to 76.7% (X (1, 159) = 93.46, p < .001), diet and exercise counseling documentation increased from 85% to 100%, and statin therapy application increased from 55.1% to 72.2% (X (1, 159) = 11.55, p = .003) in eligible adults 40-75 years-old with DMII.
This initiative helps to build the body of evidence regarding useful interventions to improve primary prevention of CVD by improving clinician adherence to the clinical care guidelines for 40- to 75-year-old adults with DMII.
本项目旨在通过互动式教育、电子警报以及在家庭医疗初级保健环境中开展的关于胆固醇治疗与管理的质量改进会议,提高家庭医疗临床医生对美国心脏病学会/美国心脏协会(2013年)以及美国糖尿病协会(ADA,2016年)针对40至75岁2型糖尿病(DMII)成人预防心血管疾病(CVD)临床实践指南的依从性。
对一家家庭医疗诊所的159份病历进行了回顾性前后对照分析。病历回顾纳入了年龄在40至75岁且诊断为DMII的患者。
分析了三项结果。在40至75岁符合条件的DMII成人中,动脉粥样硬化性心血管疾病风险评分的评估从0%增至76.7%(X(1, 159) = 93.46,p <.001),饮食和运动咨询记录从85%增至100%,他汀类药物治疗的应用从55.1%增至72.2%(X(1, 159) = 11.55,p =.003)。
该倡议有助于通过提高临床医生对40至75岁DMII成人临床护理指南的依从性,积累有关改善CVD一级预防的有效干预措施的证据。