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theses

BACKGROUND: Literature demonstrates that over the years primary care practices have been failing to comply with evidence based guidelines in treating their patients. One study demonstrated that only 50% of patients receive recommended preventative care, 60% receive recommended care for acute conditions, and 70% receive recommended care for chronic conditions. [1] As a result, studies show that many patients end up going to the emergency room repeated times for conditions that could have been properly treated by primary care doctors. [2], [3] Consequently, this study aims to determine how often primary care practices are complying with evidence based guidelines in select topics (i.e. treatment of hyperlipidemia, screening for men’s preventative health, and screening for stroke/heart disease prevention), and whether or not raising awareness to lack of compliance will increase compliance. METHODS: Data was collected over a sample of 40 family practices in New Jersey between Academic years 2015-17. 344 students conducted analyses on an appropriate random selection of patient charts to determine how often their practices were meeting guidelines for a topic of interest. They then discussed the results with their preceptor and summarized the interaction as well as results in a 5-page paper. RESULTS: Post-discussion of results with preceptor, it was found that there were improvements to compliance to guidelines in 2/6 categories for treatment of hyperlipidemia, 6/12 categories for screening of men’s preventative health, and 4/6 categories in screening for stroke and heart disease prevention. It was also found that there were statistically significant improvements in blood pressure readings and cholesterol levels for patients being treated for hyperlipidemia, however, there were no notable improvements in patients that were screened for appropriate treatment for stroke/heart disease prevention. CONCLUSION: Consistently raising awareness to practice performance through the use of QA/QI data can increase compliance to evidence based practice as well as have an impact on patient outcomes. Further studies should investigate techniques that can assist providers in keeping up to date with their performance as well as the most recent literature.

ETD_8972

Ph.D.

Includes bibliographical references

by Christine Ramdin

doi:10.7282/T3639T27

ETD doctoral

The author owns the copyright to this work.