title: Increased adherence to cardiac standards of care during participation in cardiac disease management programs.
abstract: Adherence to cardiovascular disease standards of care is critically important for minimizing the risk of mortality and morbidity for individuals with coronary heart disease (CHD) and heart failure (HF). The purpose of this study was to assess the ability of cardiac disease management (DM) programs to assist members with their adherence to evidence-based medicine for cardiovascular diseases. A total of 20,202 members with CHD and/or HF were evaluated 12 months prior to the start of DM programs and during their first 12 months of participation in the programs. Members were assessed for their adherence to appropriate cardiac medications. In addition, low-density lipoprotein (LDL) testing rates and clinical control of LDL values (defined as <100 mg/dL) were measured. The association between LDL control and use of lipid-lowering statins also was assessed. During participation in the cardiac programs, members achieved significant improvement in their adherence to angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and beta-blockers (P < 0.0001). The cardiac population also achieved a significant increase in LDL testing rates and statin use (P < 0.0001). More members attained appropriate LDL control in year 1 compared to baseline (36% relative increase), and this improvement was associated with a 40% relative increase in statin use. In summary, participation in these cardiac DM programs assisted members to improve their adherence to cardiac medications and standards of care guidelines. Such improvements in cardiovascular disease care are likely associated with improved quality of life and reduced risk for mortality.
authors.affiliation: Healthways, Inc., Nashville, Tennessee 37215, USA.
authors.forename: Carter
authors.initials: C
authors.lastname: Coberley
authors.forename: Greg
authors.initials: G
authors.lastname: Morrow
authors.forename: Matthew
authors.initials: M
authors.lastname: McGinnis
authors.forename: Aaron
authors.initials: A
authors.lastname: Wells
authors.forename: Sadie
authors.initials: S
authors.lastname: Coberley
authors.forename: Patty
authors.initials: P
authors.lastname: Orr
authors.forename: Dexter
authors.initials: D
authors.lastname: Shurney
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D008078:Cholesterol, LDL / Q000187:drug effects*; D003324:Coronary Artery Disease / Q000188:drug therapy*; D019468:Disease Management; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006305:Health Status Indicators; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors