Abstract:
Cardiovascular disease (CVD) is the leading cause of death in the United States (US). One of the most important things primary care providers (PCP) can do to prevent CVD is using primary prevention treatments. In the practice where the project was implemented, a standardized process was not in place for identifying at-risk patients. Without this, there is no way to identify if providers were adequately assessing patients for atherosclerotic cardiovascular disease (ASCVD) risk by considering their risk-enhancing factors. One way to identify appropriate patients is by completing ASCVD risk calculation using the ASCVD Risk Estimator Plus from the American College of Cardiology and the American Heart Association. In addition, 2018 Guidelines for Cholesterol Management recommend ASCVD risk calculation on all patients 40-79. The use of this tool is free to both patients and providers through a website or mobile app. The calculator can be integrated into the Electronic Health Record (EHR) to improve ease of use however, that does not come standard. Therefore, ASCVD risk calculation was performed on all patients aged 40-79 presenting for a fasting lab visit (FLV) at a primary care practice comprised of 3 clinics in East Tennessee between January 17, 2022 and February 28, 2022. Excluded patients included: patients outside of the age range, who did not have a lipid level done at their FLV, or who had a total cholesterol (TC) level greater than 320mg/dL. Once calculation was performed, results were given to the patient’s PCP for medical decision making on primary prevention treatment. After providers were given the results, chart reviews were completed to assess for primary prevention treatment initiations or increases within three months of receiving the results. Preliminary results show that a total of 443 patients presented for a FLV during the timeframe. A total of 132 patients were ineligible due to age (n=70), not having a lipid level completed (n=61) or having a TC level greater than 320 mg/dL (n=1). A total of 133 patients did not show or rescheduled their FLV. Chart reviews are just beginning, and insufficient data is currently available regarding intervention results. Limitations to this project include: all participants were Caucasian therefore, result may not be applicable to a more diverse population, the project was completed during a pandemic where patients were hesitant to come into the office, even for FLV, and a considerable number of patients who risk calculation could not be completed on. Having ASCVD calculation integrated within the EHR could promote use by providers. Future long-term research is needed to identify the accuracy of this calculator. This calculator has been modified based on research. However, research to identify the accuracy could lead to modification of the calculation to provide the most accurate result possible. One way this can be done is through use of the calculator by providers across the US.
| Identifer | oai:union.ndltd.org:ETSU/oai:dc.etsu.edu:asrf-2003 |
| Date | 07 April 2022 |
| Creators | Foster, Kayla |
| Publisher | Digital Commons @ East Tennessee State University |
| Source Sets | East Tennessee State University |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Appalachian Student Research Forum & Jay S. Boland Undergraduate Research Symposium |
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