Abstract:
BACKGROUND:Global coronary heart disease (CHD) risk assessment is recommended to guide primary preventive pharmacotherapy. However, little is known about physicians' understanding and use of global CHD risk assessment. Our objective was to examine US physicians' awareness, use, and attitudes regarding global CHD risk assessment in clinical practice, and how these vary by provider specialty. METHODS:Using a web-based survey of US family physicians, general internists, and cardiologists, we examined awareness of tools available to calculate CHD risk, method and use of CHD risk assessment, attitudes towards CHD risk assessment, and frequency of using CHD risk assessment to guide recommendations of aspirin, lipid-lowering and blood pressure (BP) lowering therapies for primary prevention. Characteristics of physicians indicating they use CHD risk assessments were compared in unadjusted and adjusted analyses. RESULTS:A total of 952 physicians completed the questionnaire, with 92% reporting awareness of tools available to calculate CHD global risk. Among those aware of such tools, over 80% agreed that CHD risk calculation is useful, improves patient care, and leads to better decisions about recommending preventive therapies. However, only 41% use CHD risk assessment in practice. The most commonly reported barrier to CHD risk assessment is that it is too time consuming. Among respondents who calculate global CHD risk, 69% indicated they use it to guide lipid lowering therapy recommendations; 54% use it to guide aspirin therapy recommendations; and 48% use it to guide BP lowering therapy. Only 40% of respondents who use global CHD risk routinely tell patients their risk. Use of a personal digital assistant or smart phone was associated with reported use of CHD risk assessment (adjusted OR 1.58; 95% CI 1.17-2.12). CONCLUSIONS:Reported awareness of tools to calculate global CHD risk appears high, but the majority of physicians in this sample do not use CHD risk assessments in practice. A minority of physicians in this sample use global CHD risk to guide prescription decisions or to motivate patients. Educational interventions and system improvements to improve physicians' effective use of global CHD risk assessment should be developed and tested.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Shillinglaw B,Viera AJ,Edwards T,Simpson R,Sheridan SLdoi
10.1186/1472-6963-12-20subject
Has Abstractpub_date
2012-01-24 00:00:00pages
20issn
1472-6963pii
1472-6963-12-20journal_volume
12pub_type
杂志文章abstract:BACKGROUND:Decentralization through the establishment of hospital governing boards has been touted as an effective way to improve the quality and efficiency of hospitals in low-income countries. Although several studies have examined the process of decentralization, few have quantitatively assessed the implementation o...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-178
更新日期:2014-04-17 00:00:00
abstract:BACKGROUND:In France, equality in access to screening has been one of the main thrusts of public policies implemented between 2009 and 2013 (the national cancer plan). Our aim in this study was to analyse the obstacles to and levers for breast, cervical, and colorectal cancer screening uptake and their trends over time...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-465
更新日期:2014-10-04 00:00:00
abstract:BACKGROUND:Globally, almost 4 million newborns die during the first 4 weeks of life every year. By increased use of evidence-based knowledge in the healthcare system a large proportion of these neonatal deaths could be prevented. But there is a severe lack of knowledge on effective methods for successful implementation...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1472-6963-11-239
更新日期:2011-09-27 00:00:00
abstract:BACKGROUND:Health care on equal terms is a cornerstone of the Swedish health care system. Total hip arthroplasty (THA) is considered a success story in Sweden with low frequency of reoperations and restored health-related quality of life (HRQoL). Administratively, health care in Sweden is locally self-governed by 21 co...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-019-4171-5
更新日期:2019-05-30 00:00:00
abstract:BACKGROUND:The number of type 2 diabetes mellitus (T2DM) patients and related treatment costs are rapidly increasing. Consequentially, more cost-effective and efficient strategies for the treatment of T2DM are needed. One such strategy is improving patients' self-management. As patients are more and more expected to se...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4384-7
更新日期:2019-08-28 00:00:00
abstract:BACKGROUND:Limited access to drugs is a crucial barrier to reducing the growing impact of cancer in low- and middle-income countries. Approaches based on drug donations or adaptive pricing strategies yield promising but varying results across countries or programs, The Glivec International Patient Assistance Program (G...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-304
更新日期:2013-08-10 00:00:00
abstract:BACKGROUND:Family-friendly spaces for children and families to visit inpatient mental health units are recommended in international mental health guidelines as one way to provide service delivery that is responsive to the needs of parent-consumers and families. There is a lack of evidence on the implementation of famil...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0914-0
更新日期:2015-06-19 00:00:00
abstract:BACKGROUND:By tradition, the Swedish health care system is based on a representative and parliamentary form of government. Recently, new management forms, inspired by market principles, have developed. The steering system is both national and regional, in that self-governing county councils are responsible for the fina...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3436-8
更新日期:2018-08-06 00:00:00
abstract:BACKGROUND:The Bulgarian and Greek Medical Care systems have been reformated the last fifteen years. The aim of this study was an examination and comparison of the Bulgarian and Greek Medical Care Systems. METHODS:This study was prepared by using all the published data related to both Bulgarian and Greek Medical Care ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-5-41
更新日期:2005-05-28 00:00:00
abstract:BACKGROUND:Psychosocial job characteristics require nursing staff with high self-consistency and good mental health. However, the attention and effort of such study remained very limited in China. METHODS:A self-administered questionnaire was distributed to the bedside nurses in an affiliated hospital of Hebei Medical...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1463-x
更新日期:2016-06-28 00:00:00
abstract:BACKGROUND:Hospital treatment for hip fracture is complex, often involving sequential episodes for acute orthopaedics, rehabilitation and care of contingent conditions. Most reports of hospital length of stay (LOS) address only the acute phase of care. This study identifies the frequency and mean duration of the compon...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0697-3
更新日期:2015-01-22 00:00:00
abstract:BACKGROUND:Peripheral intravenous catheters (PIVCs) account for a mean of 38% of catheter associated bloodstream infections (CABSI) with Staphylococcus aureus, which are preventable if deficiencies in best practice are addressed. There exists no feasible and reliable quality surveillance tool assessing all important ar...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-019-4497-z
更新日期:2019-09-05 00:00:00
abstract:BACKGROUND:Evidence-based clinical algorithms (EBCA) are knowledge tools to promote evidence use by codifying evidence into action plans to facilitate appropriate care. However, their impact on process and outcomes of care varies considerably across practice settings and providers, highlighting the need for tailoring o...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4008-2
更新日期:2019-03-20 00:00:00
abstract:BACKGROUND:Secondary prevention is important for reducing both mortality and morbidity of patients with coronary heart disease (CHD). Pharmacists can provide medication and also work on disease management for patients with CHD. This review has been carried out to evaluate the role of pharmacist care on mortality, morbi...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/1472-6963-13-461
更新日期:2013-11-04 00:00:00
abstract:BACKGROUND:The role of a pharmacist in primary health care settings of Pakistan is still obscure. Thus, we aimed to demonstrate the pharmacist-led improvements in glycemic, blood pressure and lipid controls in type 2 diabetes mellitus (T2DM) patients of Lahore, Pakistan. METHODS:The first open label, randomized contro...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12913-019-4274-z
更新日期:2019-06-24 00:00:00
abstract:BACKGROUND:Electronic health (e-Health) interventions are emerging as an effective alternative model for improving secondary prevention of coronary artery disease (CAD). The aim of this study was to describe the effectiveness of different modes of delivery and components in e-Health secondary prevention programmes on a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4106-1
更新日期:2019-06-10 00:00:00
abstract:BACKGROUND:The Whole Systems Demonstrator was a large, pragmatic, cluster randomised trial that compared telehealth with usual care among 3,230 patients with long-term conditions in three areas of England. Telehealth involved the regular transmission of physiological information such as blood glucose to health professi...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/1472-6963-14-334
更新日期:2014-08-06 00:00:00
abstract:BACKGROUND:Our objective is to estimate the effects of therapeutic oxytocin supply chain factors and social determinants of health on patient access to oxytocin in low-income settings using system dynamics modeling. Postpartum hemorrhage (PPH), a major cause of maternal mortality disproportionately affects women in low...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3452-8
更新日期:2018-08-17 00:00:00
abstract:BACKGROUND:Overcrowding of high-level health facilities is a major concern in a Vietnamese health system. This may increase an economic burden to the households since health insurance is still insufficient in providing financial risk protection. This paper sought to examine the association between the use of high-level...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4115-0
更新日期:2019-05-21 00:00:00
abstract:BACKGROUND:In Vietnam, the health-sector reforms since 1989 have lead to a rapid increase in out-of-pocket expenses. This paper examines the choice of medical provider and household healthcare expenditure for different providers in a rural district of Vietnam following healthcare reform. METHODS:The study consisted of...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-162
更新日期:2008-07-30 00:00:00
abstract:BACKGROUND:A Personal Health Record (PHR) is an electronic record that individuals use to manage and share their health information, e.g. data from their medical records and data collected by apps. However, engagement with their record can be low if people do not find it beneficial to their health, wellbeing or interac...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3254-z
更新日期:2018-06-14 00:00:00
abstract:BACKGROUND:In Japan, as the number of elderly covered by the Long-term Care Insurance (LTCI) system has increased, demand for long-term care services has increased substantially and consequently growing expenditures are threatening the sustainability of the system. Understanding the predictive factors associated with l...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-103
更新日期:2011-05-17 00:00:00
abstract:BACKGROUND:Hospitals in European countries apply a wide range of quality improvement strategies. Knowledge of the effectiveness of these strategies, implemented as part of an overall hospital quality improvement system, is limited. METHODS/DESIGN:We propose to study the relationships among organisational quality impro...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-10-281
更新日期:2010-09-24 00:00:00
abstract:BACKGROUND:The adherence pattern of antiepileptic drugs (AEDs) among patients with epilepsy is relatively lower in the United States and different European countries. However, adherence and cost analysis of AEDs in Asian countries have not been thoroughly studied. Therefore, the present study aimed to analyze the cost ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-021-06085-0
更新日期:2021-01-19 00:00:00
abstract:BACKGROUND:The disparity between government health expenditures across regions is more severe in developing countries than it is in developed countries. The capitation subsidy method has been proven effective in developed countries in reducing this disparity, but it has not been tested in China, the world's largest dev...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1635-8
更新日期:2016-08-19 00:00:00
abstract:BACKGROUND:The Floresco integrated service model was designed to address the fragmentation of community mental health treatment and support services. Floresco was established in Queensland, Australia, by a consortium of non-government organisations that sought to partner with general practitioners (GPs), private mental...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4501-7
更新日期:2019-10-14 00:00:00
abstract:BACKGROUND:Human resources play a critical role in encouraging efficient performance within organisations, especially for public healthcare organisations, where competences of staff are key aspects of the quality of services provided. In this context, the enhancement of competences are strategic objectives for Human Re...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05179-5
更新日期:2020-04-15 00:00:00
abstract:BACKGROUND:Attention to culture and its impact on health care can improve the quality of care given, add to our understanding of health care among culturally diverse populations, and encourage a more holistic approach to health care within general care. Connection to culture is important to Aboriginal peoples, and inte...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4322-8
更新日期:2019-07-12 00:00:00
abstract:BACKGROUND:Client satisfaction is the best indicator of quality service provision and has been found to correlate with continuity of care perceived by the client. The measurement of client satisfaction helps in understanding willingness and decisions to return for future services. Thus, this study aimed at assessing th...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4475-5
更新日期:2019-09-02 00:00:00
abstract:BACKGROUND:Many countries have introduced elements of managed competition in their healthcare system with the aim to accomplish more efficient and demand-driven health care. Simultaneously, generating and reporting of comparative healthcare information has become an important quality-improvement instrument. We examined...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-9-167
更新日期:2009-09-17 00:00:00