A comprehensive analysis of dyslipidaemia management in a large health care system.

{"article_title":"A comprehensive analysis of dyslipidaemia management in a large health care system.","author":"Khatana SA, Jiang L, Wu WC","journal_title":"Journal of evaluation in clinical practice","issn":"1365-2753","isbn":"","publication_date":"2014 Feb","volume":"20","issue":"1","first_page":"81","page_count":"","accession_number":"24118549","doi":"10.1111\/jep.12082","publisher":"Wiley-Blackwell","doctype":"Journal Article","subjects":"United States; Dyslipidemias therapy; Hospitals, Veterans statistics & numerical data; Patient Education as Topic organization & administration; Aged; Aged, 80 and over; Coronary Artery Disease epidemiology; Diabetes Mellitus epidemiology; Dyslipidemias epidemiology; Female; Guideline Adherence; Health Behavior; Humans; Male; Medication Adherence; Middle Aged; Patient Care Team; Practice Guidelines as Topic; Socioeconomic Factors; United States","interest_area":["Cardiology"," Internal\/Family Medicine"],"abstract":"Rationale, Aims and Objectives: Dyslipidaemia is a cardiovascular risk factor, and national screening and treatment guidelines have been established, but achievement of these remains inadequate. Multidisciplinary approaches, such as the chronic care model, have been applied to other chronic diseases and likely would be applicable to the management of dyslipidaemia. We therefore aimed to comprehensively study the different components of a multidisciplinary management approach to dyslipidaemia in a large health care system for patients at a high risk for cardiovascular events. Methods: All patients at a Veterans Affairs Medical Center in the United States over 3 years with diabetes and\/or coronary artery disease were included. Various clinical and demographic variables were collected and achievement of national cholesterol goals was determined. Univariate and multivariate analyses were conducted to determine the association of different health care variables with improved patient cholesterol guideline achievement. Results: There were 3559 patients in the study population and 51.0% had achieved national cholesterol goals. Multivariate analyses showed that patients who had achieved goals were more likely to have attended cardiology clinic [odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.3-2.01] and nutrition clinic (OR = 1.3, 95% CI = 1.04-1.7) and were more likely to have primary care providers who were nurse practitioners (OR = 1.6, 95% CI = 1.2-2.0), practicing full-time (OR = 1.8, 95% CI = 1.5-2.1) and at the main hospital-based clinics (OR = 1.5, 95% CI = 1.3-1.9). Conclusions: Our study identifies different components of a multidisciplinary approach to management of dyslipidaemia that are efficacious and these results may help guide future investment in this area. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=24118549&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Khatana SA, Jiang L, Wu WC","Journal_Info":"Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9609066 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2753 (Electronic) Linking ISSN: 13561294 NLM ISO Abbreviation: J Eval Clin Pract Subsets: MEDLINE","Publication_Type":"Journal Article","Published_Date":"2014-02-01","Source":"Journal of evaluation in clinical practice [J Eval Clin Pract] 2014 Feb; Vol. 20 (1), pp. 81-7. Date of Electronic Publication: 2013 Sep 30.","Languages":"English","Electronic_ISSN":"1365-2753","MeSH_Terms":"Dyslipidemias\/*therapy , Hospitals, Veterans\/*statistics & numerical data , Patient Education as Topic\/*organization & administration, Aged ; Aged, 80 and over ; Coronary Artery Disease\/epidemiology ; Diabetes Mellitus\/epidemiology ; Dyslipidemias\/epidemiology ; Female ; Guideline Adherence ; Health Behavior ; Humans ; Male ; Medication Adherence ; Middle Aged ; Patient Care Team ; Practice Guidelines as Topic ; Socioeconomic Factors ; United States","Subjects":"Aged, Aged, 80 and over, Coronary Artery Disease epidemiology, Diabetes Mellitus epidemiology, Dyslipidemias epidemiology, Female, Guideline Adherence, Health Behavior, Humans, Male, Medication Adherence, Middle Aged, Patient Care Team, Practice Guidelines as Topic, Socioeconomic Factors, United States, Dyslipidemias therapy, Hospitals, Veterans statistics & numerical data, Patient Education as Topic organization & administration","Title_Abbreviations":"Journal of evaluation in clinical practice","Volume":"20"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"24118549","RelevancyScore":"769","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"769.484924316406"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=24118549&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=24118549&authtype=shib&custid=ns346513&group=main&profile=eds"}