Changes in Care After Implementing a Multifaceted Intervention to Improve Preventive Cardiology Practice in Rheumatoid Arthritis
| Autor: | Darcy S. Majka, Ji Young Lee, Elisha M. Friesema, Dawid Lipiszko, Yaw A. Peprah, Stephen D. Persell, Eric Ruderman |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Statin Quality management medicine.drug_class Disease Affect (psychology) Clinical decision support system Feedback Arthritis Rheumatoid 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Intervention (counseling) medicine Humans 030212 general & internal medicine Quality Indicators Health Care Quality of Health Care business.industry 030503 health policy & services Health Policy Middle Aged Decision Support Systems Clinical medicine.disease Quality Improvement Rheumatology Cardiovascular Diseases Rheumatoid arthritis Emergency medicine Female Hydroxymethylglutaryl-CoA Reductase Inhibitors 0305 other medical science business Risk Reduction Behavior |
| Zdroj: | American Journal of Medical Quality. 34:276-283 |
| ISSN: | 1555-824X 1062-8606 |
| DOI: | 10.1177/1062860618798719 |
| Popis: | Rheumatoid arthritis (RA) increases cardiovascular disease (CVD) risk. However, CVD risk factor identification and treatment is often inadequate. The authors implemented a multifaceted rheumatology practice intervention to improve CVD risk factor measurement, assessment, and management. The intervention included clinician education, point-of-care decision support, feedback, and care management. The authors measured quality indicators from electronic health records and assessed impact with interrupted time series. Following the intervention, more RA patients had all major CVD risk factors assessed (53% vs 72.2%), and the rate of increase was greater during the intervention period than baseline (difference of 0.74% per month, P = .0016). Moderate- or high-intensity statin prescribing increased (21.6% to 28.2%), but the rate of change was not different from baseline. Several other quality measures did not increase. Although CVD risk factor assessment improved, the intervention did not affect risk factor management and control. Other strategies are needed to optimize CVD prevention in RA. |
| Databáze: | OpenAIRE |
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