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Overcoming inertia: improvement in achieving target low-density lipoprotein cholesterol.(TRENDS FROM THE FIELD)(Report)
- Article from:
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American Journal of Managed Care
- Article date:
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September 1, 2007
- Author:
- Goldberg, Kenneth C.; Melnyk, Stephanie D.; Simel, David L.
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Copyright informationCOPYRIGHT 2007 Ascend Media. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)
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Objective: To improve lipid management of high-risk patients in a large academic primary care practice.
Study Design: Educational intervention with historical controls.
Methods: We determined the likelihood of providers within an academic Veterans Affairs primary care practice to adjust simvastatin doses before and after a low-cost educational intervention. Study patients were enrolled during a 2-year preintervention period, had an indication to achieve a low-density lipoprotein cholesterol (LDL-C) level of
Results: Initially, 49% of 4048 patients met their LDL-C target. Before the intervention, the simvastatin dose was changed at only 16% of 2103 patient visits ...
<100 mg/dL, n (%)
([dagger])
Diabetes alone 1713 (42) 623 (44)
Coronary artery disease
alone 1401 (35) 439 (31)
Diabetes and coronary
artery disease 934 (23) 352 (25)
Patients who were adherent,
n (%)([dagger]) 3448 (85) 1226 (87)
Mean LDL-C value at index
visit (SD), mg/dL ([double
dagger]) 107 (35) 93 (27)
* A total of 924 patients in the postintervention group (65%) were also
in the preintervention group.
([dagger]) P>
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AAFP constructs definitions related to primary care. (American Academy of...
American Family Physician;
November 1, 1994 ;
Kahn, Norman B., Jr. Ostergaard, Daniel J. Graham, Robert;
787 words
......Physicians first carved a definition of primary care in 1975, and that definition served...ramifications of the definition of primary care have created much controversy over what constitutes primary care. Without a generally accepted definition...
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MedPAC: primary care is undervalued.(News)
Family Practice News;
April 1, 2008 ;
Ault, Alicia;
553 words
...WASHINGTON -- Saying that primary care is undervalued, the Medicare Payment...Congress increase payment for primary care and pilot test a medical home...Medicare fee schedule upward for primary care and to start a medical home pilot...
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Primary care - an overview
Community Practitioner;
October 1, 2003 ;
Porter, Elizabeth;
313 words
...Primary care an overview The challenge for primary care Nigel Starey Radcliffe Medical Press, 2003 ISBN 1 85775...gives an informative presentation on the challenges facing primary care and the UK health and welfare system. The book sets the...
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ACTION NEEDED TO STOP DEMISE OF PRIMARY CARE
US Fed News Service, Including US State News;
August 30, 2006 ;
719 words
......issued the following press release: Primary care medicine faces a serious crisis that...a "perspective" piece on this topic. Primary care refers to services provided by patients...or general pediatricians. "A strong primary care base for a health system improves care...
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NHS announces crucial investment in new research; GBP3.5m awards boost for...
M2 Presswire;
October 3, 2000 ;
787 words
......new research; GBP3.5m awards boost for primary care development (C)1994-2000 M2 COMMUNICATIONS...Development, Sir John Pattison. The National Primary Care Award Scheme funds important new research...high quality patient care in crucial primary care services. The scheme allows ...
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Primary care: an idea in search of a paradigm? (Medicine and Society)
American Family Physician;
February 1, 1993 ;
Simpson, Lisa Lee, Philip R.;
787 words
......sponsored the first national conference on primary care, with the explicit purpose of assessing the role primary care plays in the delivery of health care...strategies for health care reform, primary care medicine has emerged as a potentially...
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Development of A Multidisciplinary Primary Care Program at The Drew...
Journal of the National Medical Association;
April 1, 1998 ;
Hamilton, Lewis A; Towns, A Belinda; Edelstein, Ronald A;
787 words
...This article describes a required primary care curriculum for all third and fourth...clinical requirements. Key features of the primary care core curriculum in the third year include...populations, a weekly didactic conference on primary care and society, a weekly clinical workshop...
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The crisis of primary care physicians
The Boston Globe;
May 29, 2008 ;
Annie Brewster; Dr. Annie Brewster is an urgent care physician at Massachusetts General Hospital.;
667 words
......explained that I would no longer be her primary care doctor. I was leaving the field after...three years. "I have had three different primary care doctors over the past 10 years," she...now. I can't keep changing doctors!" Primary care is in crisis. Current primary care ...
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Commentary: primary care and health outcomes: a health services research...
Health Services Research;
December 1, 2007 ;
Starfield, Barbara Shi, Leiyu;
787 words
...The contributions of primary care to improvements in many aspects...health systems based on strong primary care have better health at lower costs...initiatives directed at strengthening primary care, including increases in the supply...
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Evaluating the Effectiveness of On-Site Mental Health in Primary Care: A...
Families, Systems & Health;
September 22, 2000 ;
CAMPBELL, THOMAS L. McDANIEL, SUSAN H.;
784 words
......recently, many GPs have added to the primary care team a mental health practitioner, a...counselor or therapist. The Counselling in Primary Care Trust, directed by pediatrician Graham...promote and professionalize counseling in primary care. Now they have commissioned a ...
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Health care reform: does primary care mean, 'whoever gets there first'?
American Family Physician;
August 1, 1994 ;
Rodney, Wm. Macmillan;
787 words
......experts to serve their own ends. The term primary care physician seems to have fallen prey...reform - where value is being placed on primary care[1,2] - physicians of various specialties are now ready to declare themselves as primary care physicians.[3] Primary care has ...
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PRIMARY CARE STANDARDS
US Fed News Service, Including US State News;
May 17, 2006 ;
787 words
......establishes basic standards expected of primary care services provided in VHA. 2. BACKGROUND...has provided guidance for implementing primary care services throughout the VA health system...Institute of Medicine's definition of primary care provides the foundation of VHA ...
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THE CHANGING CONTEXT OF PRIMARY CARE
Public Finance and Management;
January 1, 2006 ;
Peckham, Stephen;
787 words
......paper considers the changing role of primary care both within the NHS, but also in health...considers other mechanisms through which primary care has been broadened, including the introduction...financing. It suggests that changes in primary care have considerable potential to ...
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COMPARISON STUDY SHOWS U.S. LOW IN PRIMARY CARE PHYSICIAN VISITS
US Fed News Service, Including US State News;
June 13, 2007 ;
787 words
......total of about 30 minutes a year with a primary care physician in a system that is less comprehensive...according to a new study comparing primary care practice in the three countries. Findings...of California, San Francisco. The US primary care average is inadequate for meeting ...
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