Working with the Northwestern Medical Enterprise Data Warehouse, a sophisticated EHR data repository developed jointly by Northwestern University, Northwestern Memorial Hospital, and the Northwestern Memorial Faculty Foundation, researchers identified a pool of at-risk patients who were not being treated with cholesterol-lowering drugs.
Physicians in the test group received automated notification of these high-risk patients, who were then mailed personalized risk assessments. The assessments encouraged them to discuss risk-lowering options with their physicians.
Ultimately, those in the test group were twice as likely as the control group to receive a prescription for lipid-lowering medication, and after extended follow-up 18 months later, 22 percent had lowered their cholesterol significantly (by 30 mg/dl or more) vs. 16.1 percent of controls.
Though these tactics improved results compared to usual care with no follow-up messages, Persell believes there is still room for improvement.
"Many patients who had increased cardiovascular risk and got the risk message sent to them still did not get their cholesterol lowered. Future studies can examine if repeated exposure to these messages leads to bigger changes over time," he said.
Persell said an ongoing study is currently testing whether a similar approach combined with telephone outreach can help patients in federally qualified community health centers control their cardiovascular disease risk.
Approaches like this can also be tested to speed adoption of the new preventive cardiology guidelines from the National Institutes of Health once the guidelines are released.
Feinberg's Donald Lloyd-Jones, MD, senior associate dean for clinical and translational research and chair of preventive medicine, and David Baker, chief of medicine-general internal medicine and geriatrics, were also co-authors on the study.
|Contact: Marla Paul|