An initiative to improve primary prevention of cardiovascular disease in adults with type II diabetes based on the ACC/AHA (2013) and ADA (2016) guidelines

J Am Assoc Nurse Pract. 2017 Oct;29(10):606-611. doi: 10.1002/2327-6924.12492. Epub 2017 Aug 3.

Abstract

Purpose: This project was designed to increase family practice clinicians' adherence to the American College of Cardiology/American Heart Association (2013) and American Diabetes Association (ADA, 2016) clinical practice guidelines for the prevention of cardiovascular disease (CVD) in 40- to 75-year-old adults with type II diabetes (DMII) through interactive education, an electronic alert, and quality improvement sessions on the treatment and management of cholesterol in a family practice primary care setting.

Data sources: A pre- and postretrospective chart review of 159 charts from a family practice clinic was conducted. Included in the chart review were 40- to 75-year-olds with a diagnosis of DMII.

Conclusions: Three outcomes were analyzed. Assessment of Atherosclerotic Cardiovascular Disease risk score increased from 0% to 76.7% (X2 (1, 159) = 93.46, p < .001), diet and exercise counseling documentation increased from 85% to 100%, and statin therapy application increased from 55.1% to 72.2% (X2 (1, 159) = 11.55, p = .003) in eligible adults 40-75 years-old with DMII.

Implications for practice: This initiative helps to build the body of evidence regarding useful interventions to improve primary prevention of CVD by improving clinician adherence to the clinical care guidelines for 40- to 75-year-old adults with DMII.

Keywords: Nurse practitioners; advanced practice nursing; cardiovascular disease; evidence-based practice; family practice; patient education; primary prevention; type II diabetes.

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / prevention & control*
  • Diabetes Mellitus, Type 2 / therapy*
  • Dyslipidemias / therapy
  • Family Practice / standards*
  • Female
  • Guideline Adherence / standards
  • Humans
  • Male
  • Middle Aged
  • Patient Outcome Assessment
  • Primary Prevention / methods
  • Primary Prevention / standards
  • Retrospective Studies
  • Risk Factors
  • United States