Year of Publication

2017

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Judi Daniels

Clinical Mentor

Jessica Sass

Committee Member

Dr. Elizabeth Tovar

Abstract

Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in the United States and accounts for more than 17.3 million deaths per year with hyperlipidemia as one of the leading risk factors. The 2013 American Heart Association/American College of Cardiology (AHA/ACC) hyperlipidemia guideline recommends healthy lifestyle habits, risk estimation of the development of cardiovascular disease using a risk calculator, and intensity dosed statin therapy. There has been controversy among providers resulting in confusion and inconsistent application of the guideline. Purpose: The purpose of this project was to examine provider adherence to the AHA/ACC hyperlipidemia guideline in a primary care clinic. The evaluation included appropriate intensity statin therapy according to the ASCVD risk score and evidence of provider discussion of healthy lifestyle habits. Methods: A retrospective chart review was conducted in which 150 patients between the ages of 45 to 75 were randomly selected who had an active diagnosis of hyperlipidemia and were currently on statin therapy. Documentation was reviewed for discussion of healthy lifestyle habits, a calculated ASCVD risk score, and appropriate intensity statin therapy. Data was reviewed in 2015 and 2016. Results: In this sample, 40% of patients with hyperlipidemia were not receiving the recommended statin therapy based on their ASCVD risk score, which had been calculated by the provider on 23% of patients. Of statistical significance (p = 0.001), men (63%) were on appropriate intensity statin therapy, more often than women (37%). Discussion of lifestyle modifications took place in 50% of the visits. Conclusion: Based on the results of this review, there is room for improvement among providers in the evaluation and treatment of hyperlipidemia patients recommended by the 2013 guideline.

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