A systematic approach to improve lipids in coronary artery disease patients participating in a cardiac rehabilitation program.
OBJECTIVE
To determine the effectiveness of an intervention, directed toward the primary care physician (PCP), to improve the number of patients treated to low-density lipoprotein cholesterol (LDL-C) goal in a cardiac rehabilitation (CR) population.


METHODS
A pre-post intervention cohort comparison using data collected from participants in a CR program with LDL-C > or =100 mg/dL at entry. The control cohort participated in CR between 1/00 and 10/02, 41.5% (n = 178) had an entry LDL-C > or =100 mg/dL. The intervention cohort participated in CR between 10/03 and 1/05, 26.4% (n = 67) had an entry LDL-C > or =100 mg/dL. The intervention group had identical treatment as the control group as well as the following: each participant with an LDL-C > or =100 mg/dL in the intervention cohort had an entry letter sent to his or her cardiologist and PCP from the programs Cardiology Medical Director, detailing the lipid goals and therapeutic options. In addition, monthly faxes on progress toward lipid goals were sent to the PCP.


RESULTS
The control cohort was less likely to achieve LDL-C goal compared with the intervention cohort (43% vs 67%, respectively; P = .001). A patient was also less likely to have a lipid medication change during CR in the control group compared with the intervention group (29% vs 42%, respectively; P = .05).


CONCLUSIONS
Use of systematic reminders directed at the PCP during CR can substantially increase the percentage of patients achieving nationally recognized LDL-C goals.
Meis
Sophia Boudoulas
SB
McConnell Heart Health Center and Riverside Methodist Hospital, OhioHealth, Columbus 43214, USA.
Snow
Richard
R
Lalonde
Michelle
M
Falko
James
J
Caulin-Glaser
Teresa
T
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D000077144:Clopidogrel; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000097:blood / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D010348:Patient Care Team; D010353:Patient Education as Topic; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011320:Primary Health Care; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors; D002784:Cholesterol; D000077144:Clopidogrel; D013988:Ticlopidine