Value of a facilitated quality improvement initiative on cardiovascular disease risk: findings from an evaluation of the Aggressively Treating Global Cardiometabolic Risk Factors to Reduce Cardiovascular Events (AT GOAL)

Details

• Alternative Title:
  J Eval Clin Pract
• Personal Author:
  Losby, Jan L. ; Osuji, Thearis A. ; House, Marnie J. ; Davis, Rachel ; Boyce, Simone Peart ; Greenberg, Michael Canter ; Whitehill, John M.
• Description:
  Rationale, aims and objectives ; In the United States, cardiovascular disease (CVD) is the leading cause of death. The US Centers for Disease Control and Prevention contracted an evaluation of the Aggressively Treating Global Cardiometabolic Risk Factors to Reduce Cardiovascular Events (AT GOAL) programme as part of its effort to identify strategies to address CVD risk factors. ; Methods ; This study analysed patient-level data from 7527 patients in 43 primary care practices. The researchers assessed average change in control rates for CVD-related measures across practices, and then across patients between baseline and a patient’s last visit during the practice’s tenure in the programme (referred to as ‘end line’) using repeated measures analysis of variance and random effects generalized least squares, respectively. ; Results ; Among non-diabetic patients, there were significant increases in control rates for overall blood pressure (74.3% to 78.0%, P = 0.0002), systolic blood pressure (70.3% to 80.6%, P = 0.0099), diastolic blood pressure (90.1% to 92.7%, P = 0.0001) and low-density lipoprotein (LDL; 48.6% to 53.1%, P = 0.0001) between baseline and end line. Among diabetic patients, there was a significant increase in diastolic blood pressure control (59.8% to 61.9%, P = 0.0141). While continuous CVD-related outcomes show an overall trend between baseline and end line, patients with uncontrolled measures at baseline showed a decrease between baseline and end line relative to their counterparts who were controlled at baseline. ; Conclusions ; Findings from the AT GOAL evaluation support the value of a facilitated quality improvement (QI) initiative on managing CVD risk.
• Subjects:
  • Adolescent
  • Adult
  • Black or African American
  • Aged
  • Aged, 80 and over
  • Benchmarking
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases
  • Cholesterol, LDL
  More +
• Keywords:
  • cardiovascular outcomes
  • diabetes mellitus
  • patient care management
  • primary health care
  • programme evaluation
  • quality improvement
• Source:
  J Eval Clin Pract. 21(5):963-970
• Pubmed ID:
  26223497
• Pubmed Central ID:
  PMC6178234
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/ ; 200-2008-27957/PHS HHSUnited States/
• Volume:
  21
• Issue:
  5
• Download URL:
  https://stacks.cdc.gov/view/cdc/59719/cdc_59719_DS1.pdf
• File Type:
  [PDF - 154.74 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:20d4e30668f7245dbceb000730c8d907bed7ce42fb82daebbe800d8f3cdca02e