title: Impact of performance improvement continuing medical education on cardiometabolic risk factor control: the COSEHC initiative.
abstract: BACKGROUND
  The Consortium for Southeastern Hypertension Control (COSEHC) implemented a study to assess benefits of a performance improvement continuing medical education (PI CME) activity focused on cardiometabolic risk factor management in primary care patients.
  
  
  METHODS
  Using the plan-do-study-act (PDSA) model as the foundation, this PI CME activity aimed at improving practice gaps by integrating evidence-based clinical interventions, physician-patient education, processes of care, performance metrics, and patient outcomes. The PI CME intervention was implemented in a group of South Carolina physician practices, while a comparable physician practice group served as a control. Performance outcomes at 6 months included changes in patients' cardiometabolic risk factor values and control rates from baseline. We also compared changes in diabetic, African American, the elderly (> 65 years), and female patient subpopulations and in patients with uncontrolled risk factors at baseline.
  
  
  RESULTS
  Only women receiving health care by intervention physicians showed a statistical improvement in their cardiometabolic risk factors as evidenced by a -3.0 mg/dL and a -3.5 mg/dL decrease in mean LDL cholesterol and non-HDL cholesterol, respectively, and a -7.0 mg/dL decrease in LDL cholesterol among females with uncontrolled baseline LDL cholesterol values. No other statistical differences were found.
  
  
  CONCLUSIONS
  These data demonstrate that our PI CME activity is a useful strategy in assisting physicians to improve their management of cardiometabolic control rates in female patients with abnormal cholesterol control. Other studies that extend across longer PI CME PDSA periods may be needed to demonstrate statistical improvements in overall cardiometabolic treatment goals in men, women, and various subpopulations.
authors.forename: JaNae
authors.initials: J
authors.lastname: Joyner
authors.forename: Michael A
authors.initials: MA
authors.lastname: Moore
authors.forename: Debra R
authors.initials: DR
authors.lastname: Simmons
authors.forename: Brian
authors.initials: B
authors.lastname: Forrest
authors.forename: Kristina
authors.initials: K
authors.lastname: Yu-Isenberg
authors.forename: Ron
authors.initials: R
authors.lastname: Piccione
authors.forename: Kirt
authors.initials: K
authors.lastname: Caton
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Lackland
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Ferrario
mesh_terms: D000328:Adult; D000368:Aged; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000517:prevention & control*; D008875:Middle Aged; D017145:Models, Educational; D010821:Physicians, Family / Q000193:education*; D011320:Primary Health Care; D015397:Program Evaluation; D058996:Quality Improvement; D012307:Risk Factors; D013022:South Carolina
keywords: PI CME; hypertension; lipid disorders; medical education; performance improvement CE; profession-physicians; quality improvement/Six Sigma/TQM