Abstract P137: Recognition of Cardiovascular Risk Factors and Implementation of Primary Prevention Interventions with Utilization of an On-Line Form

Abstract

Purpose: Awareness, documentation and management of Cardiovascular Risk Factors (CVRF) are measures of quality of care in primary and secondary prevention of Cardiovascular Disease (CVD). We measured the recognition, documentation and management of CVRF in patients at a preventive cardiology clinic with the use of a standardized on-line form. Background and Methods: An on-line “Risk Profile Form” was created by the Cardiovascular Health Clinic at the Mayo Clinic. The form automatically populates height, weight, laboratory values including lipids, fasting blood glucose, novel risk factors, and results of cardiac stress testing. Clinicians enter information on hypertension, diabetes, smoking, family history, depression, self-reported stress level, quality of life, diet and physical activity. The form uses computerized algorithms to calculate BMI, identify metabolic syndrome, calculate Framingham Risk Score, and generate recommendations for exercise, diet, and other aspects of CV prevention. The form is reviewed with the patient and added to the medical record in addition to the consultation note. We assessed a random sample of 210 preventive cardiology consultations for 2007, 2008 and 2009 and compared the recognition, documentation and management of CVRF in patients in whom the form was and was not used. Results: The “Risk Profile Form” was used for 92 of the 210 patient encounters reviewed. Detailed results are reported in Table 1 . Conclusions: Use of a simple, standardized on-line form with incorporated computerized algorithms improves identification, documentation and management of CVRF and total CVD risk. Table 1: Comparison of Risk Factor Management With and Without Use of Risk Profile Form Risk Factor Form Used Form Not Used P-Value Smoking history assessed 79 of 92 (86%) 80 of 118 (68%) 0.002 BMI documented 92 of 92 (100%) 104 of 118 (88%) 0.001 Intake of fruits, vegetables and saturated fat evaluated 91of 92 (99%) 64 of 118 (54%) 0.001 Assessment of vigorous, moderate and mild exercise 92 of 92 (100%) 107 of 118 (90%) 0.002 Metabolic syndrome assessed 82 of 92 (89%) 12 of 118 (10%) 0.001 Framingham risk score documented 86 of 92 (93%) 7 of 118 (6%) 0.001 Weight management recommendations made 88 of 92 (96%) 72 of 118 (61%) 0.001 Hypertension management discussed 17 of 18 (94%) 25 of 35 (71%) 0.06 Dyslipidemia management discussed 62 of 63 (98%) 60 of 63 (95%) 0.40