TY - JOUR
T1 - Physicians' behavior following changes in LDL cholesterol target goals
AU - Vinker, Shlomo
AU - Bitterman, Haim
AU - Comaneshter, Doron
AU - Cohen, Arnon D.
N1 - Publisher Copyright:
© 2015 Vinker et al.; licensee BioMed Central.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Background: In 01/2011 Clalit Health Services (CHS), changed the LDL-Cholesterol target definitions in its quality indicators program, from a universal target to values stratified by risk assessment based on ATP III criteria. The objective of this study is to evaluate the effect of this change on achievement of LDL-C targets and on physicians' prescriptions of statins. Methods: Setting: CHS, The largest health maintenance organization in Israel that insures above 4,000,000 beneficiaries. Results: 433,662 patients remained in the same risk groups throughout the study period; 55.8% were women; the average age was 53.0 ± 10.3 years; 63.9%, 13.4%, and 22.7% were at low, medium, and high risk respectively. After implementation, the proportion of patients reaching LDL-C targets increased in all risk groups: from 58.6% to 61.6%, from 55.1% to 61.1%, and from 44.5% to 49.0%, in low, medium, and high risk groups respectively (p < 0.001). The proportion of patients treated with potent statins increased in all risk groups; from 3.4% to 5.6%, from 6.7% to 10.3%, and from 14.5% to 20.3% respectively (p < 0.001). Conclusion: The risk stratification approach as a basis for the quality indicators program was implemented and better achievement of target LDL-C levels ensued. We suggest that implementation of quality indicators that are consistent with the current literature can lead to improvements that exceeds temporal trends.
AB - Background: In 01/2011 Clalit Health Services (CHS), changed the LDL-Cholesterol target definitions in its quality indicators program, from a universal target to values stratified by risk assessment based on ATP III criteria. The objective of this study is to evaluate the effect of this change on achievement of LDL-C targets and on physicians' prescriptions of statins. Methods: Setting: CHS, The largest health maintenance organization in Israel that insures above 4,000,000 beneficiaries. Results: 433,662 patients remained in the same risk groups throughout the study period; 55.8% were women; the average age was 53.0 ± 10.3 years; 63.9%, 13.4%, and 22.7% were at low, medium, and high risk respectively. After implementation, the proportion of patients reaching LDL-C targets increased in all risk groups: from 58.6% to 61.6%, from 55.1% to 61.1%, and from 44.5% to 49.0%, in low, medium, and high risk groups respectively (p < 0.001). The proportion of patients treated with potent statins increased in all risk groups; from 3.4% to 5.6%, from 6.7% to 10.3%, and from 14.5% to 20.3% respectively (p < 0.001). Conclusion: The risk stratification approach as a basis for the quality indicators program was implemented and better achievement of target LDL-C levels ensued. We suggest that implementation of quality indicators that are consistent with the current literature can lead to improvements that exceeds temporal trends.
KW - Clinical guidelines
KW - Hypercholesterolemia
KW - Quality indicators
KW - Statins
UR - http://www.scopus.com/inward/record.url?scp=84930623591&partnerID=8YFLogxK
U2 - 10.1186/s13584-015-0016-9
DO - 10.1186/s13584-015-0016-9
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AN - SCOPUS:84930623591
SN - 2045-4015
VL - 4
JO - Israel Journal of Health Policy Research
JF - Israel Journal of Health Policy Research
IS - 1
M1 - 20
ER -