Eliminate not Create Disparity of Care - Expand Preventive Treatment to All High Risk Patients

No audio needed. Read and ponder. Press the pause button if you need to. Don’t promote disparity of care.

Use of Statins and Aspirin Post CABG-2

This study was published in March 2016. 33% of these 381 post CABG patients were not prescribed a statin. 57% of their saphenous vein grafts were closed. All these very high risk patients are excluded from the Million Hearts Model Trial. They are likely to remain untreated if they remain undiscovered by program that sifts through EHR database using the inclusion criteria.

Our PaKS approach and ACCEPT system include CV Risk Assessment Form and Daily EZ Chart Audit Form since 2001. I can’t think of any patient in my practice who had at least three previous visits who will qualify to be included in the study.

This is the scan of our daily chart audit. You can’t be sure that you are doing what you thought you are doing unless you perform regular chart audits.  Doing it prospectively and daily is best. I saw 17 patients on 1/11/2016 - all high/very high risk, 10/17 patients with LDLc<70, 3/17 patients with LDLc >70 to <100, 2/17 patients with LDLc>100 to <130, 1/17 patient with LDLc > 130 who is all-statin intolerant; 15/17 patients with systolic BP <130. We have accumulated over 10 years of daily prospective chart audit data. 

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