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AAPA: Cardiology Patients Require Follow-up to Ensure Compliance with Treatment Guidelines By Paul D. Thacker NEW ORLEANS, LA -- May 23, 2003 -- Many cardiology patients would benefit from follow-ups by physician assistants to ensure their treatment complies with established guidelines, according to researchers at South Central Wisconsin Heart, in Madison, United States. Findings from a study that looked at compliance with the Using the Adult Treatment Panel Guidelines (ATP III) released by National Cholesterol Education Program were presented here May 22nd at the AAPA Annual Physician Assistant Conference. Joel Rhyner, a physician assistant at South Central Wisconsin Heart and colleagues identified 150 random patients attending the hospital in 2002. They reviewed patients' goals, low-density lipoprotein (LDL) cholesterol level, and medical utilization as well as data points for age, gender, allergies, family history, total cholesterol, high-density lipoprotein (HDL) cholesterol level, triglyceride levels, liver function tests, therapeutic lifestyle changes, past cardiac events, and cardiovascular risk factors. Patients enrolled in the study were 56 women and 94 men; 15% were smokers. Mean body mass index was 28.6; 63% had hypertension and 31% had diabetes; 33% had history of myocardial infarction. Sixteen percent of enrolled patients had made therapeutic lifestyle changes. The researchers found that while all patients should have had a fasting lipid panel, only 72% had this documented in their charts, and 24% had no documented lipid lowering therapy prescribed to them. Overall, 42% of patients had reached their LDL goals based on their risk factor analysism compared to national average of 28%. Prescriptions for HMG-CoA-Reductase inhibitors or statins were noted in 69.3% of patient charts. LDL goal level attainment according to individual statin agent was as follows: 70% of patients on atorvastatin; 67% of those on pravastatin; 43% of those on fluvastatin; 41% of those on simvastatin; and none of those on lovastatin. In Chi square analysis, atorvastatin was found to be statistically superior to simvastatin for attaining LDL goal levels. Mr. Rhyner and colleagues concluded that a large population of cardiology patients is not receiving adequate care. All patients who have not received fasting lipid panels as well as those on lipid reduction therapy would benefit from physician assistant follow-ups as well as from advice on therapeutic lifestyle changes. [Abstract: Physician Assistant–Driven Analysis of Low Density Lipoprotein (LDL) Goal Attainment in Cardiology Specialty Clinic.] E-mail this page to a friend or colleague! To print, use this version