A successful physician training program in cholesterol screening and management.
A successful physician training program in cholesterol screening and management.
复制标题
胆固醇筛查和管理方面成功的医生培训计划。
DOI：
10.1016/0091-7435(91)90035-3
复制
发表时间：
1991
影响因子：
5.1
通讯作者：
Carleton,RA
中科院分区：
文献类型：
--
作者：
Jack,BW;Gans,KM;McQuade,W;Culpepper,L;Lasswell,A;Hume,AL;Dowling,PT;Carleton,RA
法36名住院医师接受了血胆固醇培训计划，其中包括使用手指针刺法和台式分析仪进行血胆固醇筛查的培训，饮食评估和咨询，以及后续饮食和药物治疗的管理协议。该计划还包括对居民的反馈，他们的血液胆固醇筛查活动，激励措施，并在部门通讯双周文章。1986-1987年期间（基线）和1987-1988（干预），目标患者人群的百分比（年龄20-65岁，未怀孕，前一年未筛查）在该初级保健实践中筛查高胆固醇血症的患者从16.2%增加到23.2% [率差（RD）= 7.0; 95%置信区间（CI）= 4.75-9.25]。筛查试验的平均值从5.36 mmol/L（207.2 mg/dl）下降到5.08 mmol/L（196.6 mg/dl;t= 2.98，P = 0.003），需要进一步评估的筛查人群百分比从36.8%下降到27.6%（RD 9.2; CI = 2.00-14.00）。在干预年，与基线年相比，具有临界血胆固醇和心血管危险因素的患者更有可能进行随访检查（28.8%vs11.9%，RD = 16.9;低密度脂蛋白胆固醇检测用于筛查的比例较低（8.2%vs19.4%，P < 0.0001）。我们的结论是，该计划被有效地整合到一个忙碌繁忙的初级保健实践，导致改善血液胆固醇筛查和管理的做法。
Method. Thirty-six resident physicians received a blood cholesterol training program which included training in blood cholesterol screening using a fingerstick method and a desktop analyzer, diet assessment and counseling, and a management protocol for follow-up diet and drug treatment. The program also included feedback to residents about their blood cholesterol screening activity, incentives, and biweekly articles in the department newsletter.Results. Between 1986–1987 (baseline) and 1987–1988 (intervention), the percentage of the target patient population (ages 20–65 years, nonpregnant, not screened in the previous year) that was screened for hypercholesterolemia in this primary care practice increased from 16.2 to 23.2% [rate difference (RD) = 7.0; 95% confidence interval (CI) = 4.75–9.25]. The mean value of the screening tests decreased from 5.36 mmol/liter (207.2 mg/dl) to 5.08 mmol/liter (196.6 mg/dl;t= 2.98,P= 0.003) and the percentage of the population screened needing further evaluation decreased from 36.8 to 27.6% (RD 9.2; CI = 2.00–14.00). In the intervention year, compared with the baseline year, patients with a borderline blood cholesterol and cardiovascular risk factors were more likely to have a follow-up test (28.8% vs 11.9%, RD = 16.9; 95% CI = 0.80–33.00) and the low-density lipoprotein cholesterol test was used less for screening (8.2% vs 19.4%,P< 0.0001).Conclusion. We conclude that this program was effectively integrated into a busy primary care practice, leading to improvement in blood cholesterol screening and management practices.