Quality in Primary Care Open Access

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Evaluation of primary prevention of coronary artery disease in primary care and ways to perform better

Alok Surana

Using the USPTF guidelines to evaluate the adherence of a community hospital resident clinic to Primary prevention of CAD: use of aspirin, statins and smoking cessation. Proper implementation of these guidelines has potential to benefit millions of patients and also reduce the health care cost secondary to cardiovascular diseases

Methods: Inclusion and exclusion criteria were defined.

Inclusion criteria: • Age 45-65 • Active patient at the resident clinic (seen at least once between June 2014 – April 2015)

Exclusion criteria: • History of coronary artery disease • Aged <45 or > 65 Retrospective EMR chart review was performed. Use of aspirin, statin type and dose, allergy/ contraindication to these meds and current smoking status were tabulated.

Results: A total of 493 Patient charts were reviewed. 386 patients met the inclusion criteria. Of these only 19% (73/386) patients were on aspirin. A total of 64% (247/386) patients had high ASCVD risk and only 48% (118/247) of these were on optimal statins, while 2% (5/247) on suboptimal and 50% (124/247) were not on statins. 42% (162/386) of this non-CAD population was an active smoker.

Conclusions: The compliance to USPTF guidelines for primary prevention of CAD in resident clinic in community setting was much less than desired. Various educational measures including resident conferences and a reminder in the EMR has potential to increase the adherence to these guidelines. To see if the low rate of guideline compliance is a local phenomenon or seen in other resident clinics as well, collaboration with local residencies can be done. Address