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PDAs, more education help doctors follow cholesterol treatment guidelines
Date:4/22/2009

WINSTON-SALEM, N.C. A new study by researchers at Wake Forest University School of Medicine suggests that patients with high cholesterol receive better care when physicians use a variety of tools to learn and apply a clinical practice guideline for treating the condition.

The study, published in the April 13 issue of the Archives of Internal Medicine, tracked the adherence to clinical guidelines at 61 primary care practices. The study aimed to improve the treatment of high cholesterol by having doctors use a personal digital assistant (PDA) to assess the patient's risk of heart disease and recommend treatment. Doctors also received copies of the cholesterol guideline and an introductory lecture on it, attended additional presentations on treating high cholesterol, and received a report on their practices' performance on cholesterol management.

"We wanted to know if we could improve guideline adherence with this multifaceted strategy," said Alain G. Bertoni, M.D., M.P.H., an associate professor in the Departments of Epidemiology & Prevention and Internal Medicine, and lead author on the study. "When you look at previous quality improvement efforts, it appears that single strategies don't work that well."

Clinical guidelines aim to prevent the under- or over-treatment of a disease. Lowering high cholesterol reduces the risk of cardiovascular disease, the leading cause of death in the United States, but the National Cholesterol Education Program Adult Treatment Panel (ATP III) guideline suggests prescribing drugs only under certain conditions. The complexity of the guideline made it the perfect subject for study, Bertoni said.

"The guideline doesn't say if your LDL cholesterol is a specific level, you should treat," he said. "It says you should consider all risk factors before deciding to prescribe a lipid-lowering drug."

For the study, a decision-making tool was programmed into PDAs. The tool calculated the p
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Contact: Jessica Guenzel
jguenzel@wfubmc.edu
336-716-3487
Wake Forest University Baptist Medical Center
Source:Eurekalert

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