Article Figures & Data
Figures
- Figure 1
CONSORT 2010 flow diagram for Cholesterol Education Research Trial: HeartAge
- Figure 2
Patient-activation tool to calculate HeartAge.
- Figure 3
Example of a patient’s calculated HeartAge.
- Figure 4
LDL (A) and HDL (B) cholesterol goals over time by risk and treatment group.
C=control, CHD=coronary heart disease; HDL=high-density lipoprotein, I=intervention, LDL=low-density lipoprotein.
Note: total numbers for the study groups for each risk level are as follows: CHD equivalent risk: control base=368, follow-up=425, and intervention base=405, follow-up=450; high risk: control base=213, follow-up=248, and intervention base=180, follow-up=208; moderate risk: control base = 475, follow-up = 536, and intervention base = 360, follow-up = 448; low risk: control base=1,049, follow-up=896, and intervention base=1,055, follow-up=894. Changes in the numbers from baseline to follow-up are related to the accumulation of additional risk factors over the year of follow-up.
Tables
Characteristic Control Intervention P Value Practices, No. 15 15 Size, No. (%) Solo 8 (53) 9 (60) 0.71 Group 7 (47) 6 (40) Nurse practitioner/physician’s assistant in practice, No. (%) 5 (33) 7 (47) 0.46 Type, No. (%) Family practice 8 (53) 7 (47) 0.72 Internal medicine 7 (47) 8 (53) Hospital affiliated (n, %) 2 (13) 3 (20) 1.00 Physicians, No. 29 26 3 Age, mean (SD), y 46.7 (6.3) 46.4 (8.4) 0.94 Male, No. (%) 22 (76) 16 (62) 0.25 Years in practice, mean (SD) 15.8 (6.9) 15.0 (8.8) 0.95 Patients seen per week, mean (SD), No. 99 (46) 96 (28) 0.39 Never used PDA, No. (%) 11 (38) 13 (50) 0.21 Minutes behind at the end of the day, mean (SD), No. 18 (14.1) 23 (21.5) 0.46 Patients, No.a 2,105 2,000 3 Male, % 41.8 39.7 0.693 Marital status, % Partnered 71.0 72.3 0.53 Not partnered 29.0 27.7 Race, % American Indian 0.5 0.5 0.61 Asian 0.8 0.7 African American 1.2 1.3 White 95.7 95.8 Hispanic 1.7 1.3 Missing 0.3 0.2 CHD risk group, % CHD equivalent 18.4 21.1 0.33 High 9.8 9.2 0.73 Moderate 24.6 17.5 0.02 Low 44.4 50.4 0.25 Current smoker, % 13.8 10.8 0.21 Physically inactive, % 24.7 23.4 0.63 At LDL cholesterol goal (%) 58.9 58.4 0.89 At non-HDL cholesterol goal, % 62.3 65.5 0.33 Diagnosed lipid disorder treated with lipid medications, % 56.1 57.3 0.74 Treatment gap for lipid management, % 29.3 30.6 0.74 Medical history, % 3 3 3 COPD 7.6 5.9 0.40 Diabetes 9.6 11.2 0.27 Hypertension 45.6 41.9 0.40 Undiagnosed hypertension 3.2 3.0 0.80 Controlled hypertension 82.3 82.8 0.88 Lipid disorder 59.2 56.9 0.67 Undiagnosed lipid disorder 17.6 19.0 0.71 Overweight 5.9 8.1 0.31 Obese 17.1 17.5 0.91 Depression 25.8 25.6 0.96 GERD 20.7 22.7 0.51 Metabolic syndrome 0.7 1.6 0.18 Family history of CHD 38.4 30.2 0.35 Living with 2 or more chronic conditions 58.2 56.8 0.78 Age, mean (SE), y 52.3 (1.1) 54.0 (1.1) 0.25 Total cholesterol, mean (SE), mg/dL 193 (1.8) 193 (1.8) 0.88 LDL cholesterol, mean (SE), mg/dL 114 (1.6) 114 (1.5) 0.96 HDL cholesterol, mean (SE), mg/dL 54 (0.9) 54 (0.9) 0.53 Prescription drugs, mean (SE), No. 4.8 (1.1) 4.7 (1.1) 0.86 Chronic conditions, mean (SE), No. 2.0 (1.1) 1.9 (1.1) 0.76
Supplemental Appendixes
Supplemental Appendix 1. Details of ATP III Risk Categorization ; Supplemental Appendix 2. Details of Practice and Patient Recruitment and Randomization
Files in this Data Supplement:
- Supplemental data: Appendixes - PDF file, 2 pages, 172KB
The Article in Brief
Translating Cholesterol Guidelines Into Primary Care Practice: A Multimodal Cluster Randomized Trial
Charles B. Eaton, and colleagues
Background Underscreening and undertreatment of dyslipidemia (abnormal levels of cholesterol and/or other fat in the blood) are widespread problems. This study examines whether activating patients, by use of a computer program about the patient's risk of heart attack, and providing the primary care team with a PDA-based decision support tool result in better adherence to cholesterol guidelines and achievement of cholesterol goals.
What This Study Found This study showed no benefit to activating patients and supporting the health care team in cholesterol management. Another form of analysis, however, suggests potential benefit to this multifaceted approach.
Implications
- The authors call for further research on the use of both behavioral science and informatics to empower patients and support clinicians.
Correction
The following information has been inadvertently left off this article: Funding support: This publication was made possible by grant number 1 R01 HL070804 from the National Heart, Lung and Blood Institute. ClinicalTrials.gov registration No. NCT01242319.
