Improving adherence to treatment guidelines: a blueprint.
Patients with chronic diseases often require complex medication regimens to meet evidence-based treatment guidelines. However, translating evidence-based recommendations into clinical care has proven to be difficult. Several factors-patient adherence, disease complexity, competing medical issues, guideline dissemination, and clinical inertia-are thought to contribute to this problem. In this manuscript, we describe a multidisciplinary ambulatory approach to improve the care of patients with chronic conditions. Our goal was to design an intervention that focused on improving the prescription rates of medications known to reduce cardiovascular-related events and hospital admissions for patients with diabetes mellitus, coronary artery disease, heart failure, chronic kidney disease, or stroke. We also describe the critical lessons we have learned in implementing our intervention, including the successes and barriers we encountered during the project.
Gandara
Esteban
E
Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA.
Moniz
Thomas T
TT
Dolan
Mary Lou
ML
Melia
Caroline
C
Dudley
Jessica
J
Smith
Allen
A
Kachalia
Allen
A
D002318:Cardiovascular Diseases / Q000188:drug therapy; D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000188:drug therapy; D004363:Drug Utilization; D019983:Guideline Adherence; D006760:Hospitalization; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy; D055118:Medication Adherence; D054539:Medication Therapy Management / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D016730:Program Development