Document Detail


Changing physician practice behavior to measure and improve clinical outcomes.
MedLine Citation:
PMID:  17077421     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Physician practice behavior often produces poor clinical outcomes in the management of cardiovascular disease risk factors in spite of effective treatments and guidelines. The behavior of 165 physicians in 2 settings (suburban and urban) was studied. After collecting baseline clinical data, including systolic blood pressure and low-density lipoprotein cholesterol, a series of interventions was conducted, including academic detailing. Low-density lipoprotein cholesterol decreased 10.4% in suburban patients with cardiovascular disease in the intervention group (P = .001) and 10.5% in the enhanced intervention group (P = .001). Systolic blood pressure decreased 1.11% (P = .357) in the intervention group and 5.13% in the enhanced intervention group (P < .001). In urban hypertensive patients, systolic blood pressure decreased 5.03% (P = .001) and low-density lipoprotein cholesterol decreased 7.01% (P < .001). Combining urban and suburban data, low-density lipoprotein cholesterol decreased 9.32% (P < .001) and systolic blood pressure decreased 4.00% (P < .001). Providing physicians with their clinical outcomes, reviewing national guidelines, and setting expectations, associated with modest practice systems innovations, can produce significant measurable clinical improvements.
Authors:
Richard J Schuster; Nancy A Terwoord; Joseph Tasosa
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  American journal of medical quality : the official journal of the American College of Medical Quality     Volume:  21     ISSN:  1062-8606     ISO Abbreviation:  Am J Med Qual     Publication Date:    2006 Nov-Dec
Date Detail:
Created Date:  2006-11-01     Completed Date:  2006-12-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9300756     Medline TA:  Am J Med Qual     Country:  United States    
Other Details:
Languages:  eng     Pagination:  394-400     Citation Subset:  IM    
Affiliation:
Center for Global Health Systems, Management, and Policy, Wright State University Boonshoft School of Medicine, Kettering, Ohio 45420, USA. richard.schuster@wright.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure
Cardiovascular Diseases / ethnology,  therapy*
Female
Guideline Adherence / standards*
Humans
Lipoproteins / blood
Male
Physician's Practice Patterns / standards*
Practice Guidelines as Topic / standards*
Quality of Health Care / standards*
Suburban Population
Urban Population
Grant Support
ID/Acronym/Agency:
N01-HO-29235/HO/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Lipoproteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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