دورية أكاديمية
A system approach to improving guideline-directed therapy for cardio-renal-metabolic conditions: The 'beyond diabetes' initiative
| العنوان: | A system approach to improving guideline-directed therapy for cardio-renal-metabolic conditions: The 'beyond diabetes' initiative |
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| المؤلفون: | Benjamin J. Hirsh, Jamie S. Hirsch, Hosam Hmoud, Spencer Weintraub, Agnes Cha, Martin Lesser, Xueqi Huang, Yan Yan Sally Xie, Rachel Nahrwold, John Joshua, Jennifer Scanlon, Thomas Galella, Varinder Singh, Eugenia Gianos |
| المصدر: | American Journal of Preventive Cardiology, Vol 16, Iss , Pp 100608- (2023) |
| بيانات النشر: | Elsevier, 2023. |
| سنة النشر: | 2023 |
| المجموعة: | LCC:Diseases of the circulatory (Cardiovascular) system LCC:Public aspects of medicine |
| مصطلحات موضوعية: | Diabetes mellitus, Cardiovascular, Kidney, Outcomes, Systems-based, Initiative, Diseases of the circulatory (Cardiovascular) system, RC666-701, Public aspects of medicine, RA1-1270 |
| الوصف: | Objective: Despite demonstrating improvements in cardiovascular disease, kidney disease, and survival outcomes, guideline-directed antihyperglycemic medications such as sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like-peptide-1 receptor agonists (GLP1-RA), are underutilized. Many obstacles constrain their use including lack of systematic provider and patient education, concern for medication side effects, and patient affordability. Methods: We designed a multimodality, systems-based approach to address these challenges with the goal of increasing medication utilization across the largest healthcare system in New York State. This multispecialty collaborative included provider and patient education, an electronic health record-enabled platform to identify eligible patients, and access to pharmacists for medication guidance and addressing insurance coverage barriers. Surveys were administered following grand rounds lectures and knowledge-based questionnaires were given before and after case-based sessions for housestaff, with results analyzed using a two-sided Student's t-test. Rates of first prescriptions of SGLT2i/GLP1-RA in combined and individual analyses were compared between the pre- and post-education periods (6 months prior to 3/31/2021 and 6 months post 8/19/2021), and the change in prescriptions per 100 eligible-visits was assessed using the incidence density approach. Results: Among grand rounds participants, 69.3% of respondents said they would make changes to their clinical practice. Knowledge increased by 14.7% (p-value |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2666-6677 |
| Relation: | http://www.sciencedirect.com/science/article/pii/S2666667723001496; https://doaj.org/toc/2666-6677 |
| DOI: | 10.1016/j.ajpc.2023.100608 |
| URL الوصول: | https://doaj.org/article/1f78bb2b09d24e79b6f578a974670425 |
| رقم الأكسشن: | edsdoj.1f78bb2b09d24e79b6f578a974670425 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 26666677 |
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| DOI: | 10.1016/j.ajpc.2023.100608 |