Point-of-care testing to promote cardiovascular disease risk assessment: A proof of concept study
Updated cholesterol guidelines emphasize multivariable cardiovascular disease (CVD) risk estimation to guide treatment decision-making in primary prevention. This study tested the preliminary feasibility, acceptability and efficacy of point-of-care testing (POCT) and quantitative CVD risk assessment...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-09-01
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| Series: | Preventive Medicine Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335517300979 |
| _version_ | 1817990832496574464 |
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| author | Kunal N. Karmali Tiffany Brown Thomas Sanchez Timothy Long Stephen D. Persell |
| author_facet | Kunal N. Karmali Tiffany Brown Thomas Sanchez Timothy Long Stephen D. Persell |
| author_sort | Kunal N. Karmali |
| collection | DOAJ |
| description | Updated cholesterol guidelines emphasize multivariable cardiovascular disease (CVD) risk estimation to guide treatment decision-making in primary prevention. This study tested the preliminary feasibility, acceptability and efficacy of point-of-care testing (POCT) and quantitative CVD risk assessment in high-risk adults to increase guideline-recommended statin use in primary prevention. Participants were aged 40–75 years, without CVD or diabetes mellitus, and potentially-eligible for consideration of statins based on estimated 10-year CVD risk from last-measured risk factor levels in the electronic health record. We performed POCT to facilitate quantitative CVD risk assessment with the Pooled Cohort Equations immediately before a scheduled primary care provider (PCP) visit. Outcomes were: physician documentation of a CVD risk discussion and statin prescription on the study date. We also assessed acceptability of the intervention through structured questionnaire. We recruited 18 participants (8 from an academic practice and 10 from a federally-qualified health clinic). After the intervention, 83% of participants discussed CVD risk with their PCP, 47% received a statin recommendation from their PCP, and 29% received a new statin prescription during the PCP visit. Participants reported high levels of satisfaction with the intervention. This study demonstrates that in initial testing pre-visit POCT and quantitative CVD risk assessment appears to be a feasible and acceptable intervention that may promote guideline-recommended statin initiation in primary prevention. Future research with an adequately powered trial is warranted to determine the effectiveness of this approach in clinical practice. |
| first_indexed | 2024-04-14T01:04:03Z |
| format | Article |
| id | doaj.art-32a5e45a595e4b5a932712ea36e4debc |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-04-14T01:04:03Z |
| publishDate | 2017-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-32a5e45a595e4b5a932712ea36e4debc2022-12-22T02:21:18ZengElsevierPreventive Medicine Reports2211-33552017-09-017C13613910.1016/j.pmedr.2017.05.016Point-of-care testing to promote cardiovascular disease risk assessment: A proof of concept studyKunal N. Karmali0Tiffany Brown1Thomas Sanchez2Timothy Long3Stephen D. Persell4Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United StatesDivision of General Internal Medicine and Geriatrics, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United StatesNear North Health Services Corporation, Chicago, IL, United StatesNear North Health Services Corporation, Chicago, IL, United StatesCenter for Primary Care Innovation, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United StatesUpdated cholesterol guidelines emphasize multivariable cardiovascular disease (CVD) risk estimation to guide treatment decision-making in primary prevention. This study tested the preliminary feasibility, acceptability and efficacy of point-of-care testing (POCT) and quantitative CVD risk assessment in high-risk adults to increase guideline-recommended statin use in primary prevention. Participants were aged 40–75 years, without CVD or diabetes mellitus, and potentially-eligible for consideration of statins based on estimated 10-year CVD risk from last-measured risk factor levels in the electronic health record. We performed POCT to facilitate quantitative CVD risk assessment with the Pooled Cohort Equations immediately before a scheduled primary care provider (PCP) visit. Outcomes were: physician documentation of a CVD risk discussion and statin prescription on the study date. We also assessed acceptability of the intervention through structured questionnaire. We recruited 18 participants (8 from an academic practice and 10 from a federally-qualified health clinic). After the intervention, 83% of participants discussed CVD risk with their PCP, 47% received a statin recommendation from their PCP, and 29% received a new statin prescription during the PCP visit. Participants reported high levels of satisfaction with the intervention. This study demonstrates that in initial testing pre-visit POCT and quantitative CVD risk assessment appears to be a feasible and acceptable intervention that may promote guideline-recommended statin initiation in primary prevention. Future research with an adequately powered trial is warranted to determine the effectiveness of this approach in clinical practice.http://www.sciencedirect.com/science/article/pii/S2211335517300979Cardiovascular disease preventionRisk assessmentPoint-of-care testing |
| spellingShingle | Kunal N. Karmali Tiffany Brown Thomas Sanchez Timothy Long Stephen D. Persell Point-of-care testing to promote cardiovascular disease risk assessment: A proof of concept study Preventive Medicine Reports Cardiovascular disease prevention Risk assessment Point-of-care testing |
| title | Point-of-care testing to promote cardiovascular disease risk assessment: A proof of concept study |
| title_full | Point-of-care testing to promote cardiovascular disease risk assessment: A proof of concept study |
| title_fullStr | Point-of-care testing to promote cardiovascular disease risk assessment: A proof of concept study |
| title_full_unstemmed | Point-of-care testing to promote cardiovascular disease risk assessment: A proof of concept study |
| title_short | Point-of-care testing to promote cardiovascular disease risk assessment: A proof of concept study |
| title_sort | point of care testing to promote cardiovascular disease risk assessment a proof of concept study |
| topic | Cardiovascular disease prevention Risk assessment Point-of-care testing |
| url | http://www.sciencedirect.com/science/article/pii/S2211335517300979 |
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