NEW YORK (Reuters Health) Mar 06 – Specialized cardiac case managers can significantly improve the adherence by physicians in the hospital setting to established treatment guidelines for patients with elevated LDL levels, according to a report in the February 25th Archives of Internal Medicine.
Despite recommendations from the National Cholesterol Education Program (NCEP) that lipoprotein profiles be obtained immediately following hospital admission for coronary artery disease (CAD) and that LDL levels above 130 mg/dL be treated with lipid-lowering therapy, many such patients remain inadequately evaluated and treated, the authors explain.
Dr. Clifton R. Lacy, from the University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School in New Brunswick, and colleagues assessed the impact of an intervention aimed at improving the use of lipid-lowering therapy in hospitalized patients with CAD.
Cardiac case managers prompted physicians to order lipid profiles for CAD patients who were not receiving lipid-lowering therapy on admission and to initiate such therapy for those patients whose LDL was 130 mg/dL or higher.
The fraction of patients for whom lipid profiles were obtained increased from 27% before the intervention to 89% after the intervention, the authors report, and the percentage of patients for whom lipid-lowering therapy was appropriately initiated increased from 17% to 82%. …