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2 results

  • Addressing the underdiagnosis of familial hypercholesterolemia: A mixed methods study exploring the knowledge and practice behaviors of cardiology healthcare providers

  • Isha Kalia, Ronald Shope, Muredach Reilly, Lisa Schwartz
  • Journal:
    Journal of Clinical and Translational Science / Volume 7 / Issue 1 / 2023
    Published online by Cambridge University Press:
    05 April 2023, e92
    • Article
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  • Background:

    Familial hypercholesterolemia (FH) is vastly underdiagnosed and causes an increased risk for sudden cardiac death. Cardiology providers (CHCPs) are in an ideal position to care for FH patients. This research aimed to understand the practice behaviors of CHCPs in the screening, diagnosis, and management of FH.

    Methods:

    Adaptation of an existing FH knowledge tool guided survey development. The results of the quantitative survey guided development of the interview protocol. CHCPs were recruited in the Division of Cardiology at Columbia University Irving Medical Center (CUIMC). A review of the educational materials offered by the Division of Cardiology was conducted to identify FH knowledge domains presented.

    Results:

    CHCPs with MDs, at CUIMC for 6–10 years, in clinical practice for 1–5 years, and in inpatient services had the highest average total knowledge scores. CHCPs with RNs, at CUIMC for less than 1 year, in clinical practice for 6–10 years, and in Cath Lab had the lowest average knowledge scores. Four themes emerged – variability in FH care; issues related to addressing FH at institutional, practice setting, and individual levels; importance of identifying FH early; and intervention approaches to overcome barriers to caring for FH patients in cardiology. CHCPs with MDs or with experiential FH knowledge described FH care beyond screening. The document review revealed that only MDs were provided lectures pertaining to FH.

    Conclusions:

    Future interventions should increase didactic and experiential FH knowledge incorporating institutional, local, and national FH resources. Improving FH care can reduce FH-related morbidity and mortality, as well as improve FH health outcomes.

  • The impact of education on care practices: an exploratory study of the influence of “action plans” on the behavior of health professionals

  • Eunice Rodriguez, Renee Marquett, Ladson Hinton, Melen McBride, Dolores Gallagher-Thompson
  • Journal:
    International Psychogeriatrics / Volume 22 / Issue 6 / September 2010
    Published online by Cambridge University Press:
    01 July 2010, pp. 897-908

  • Background: There has been limited focus on evaluation of continuing education (CEU) and continuing medical education (CME) in the fields of gerontology and geriatrics. The increasing elderly population combined with the limited clinical workforce highlights the need for more effective methods of continuing education. Traditionally, outcomes of CEU and CME programs relied on self-report measures of satisfaction with the scope and quality of the training, but more recent efforts in this area have focused on outcomes indicating level of improved skills and attitudinal changes of medical and allied health professionals towards working with elderly patients in need of assistance.

    Methods: This study focused on the use of “Action Plans” as a tool to stimulate changes in clinical programs following training, along with attempting to determine typical barriers to change and how to deal with them. More than 600 action plans were obtained from participants attending various continuing education classes providing training on care of patients with dementia (PWD) and their families. Both qualitative and quantitative methods, including logistic regression models were used to analyze the data.

    Results: Three months following training 366 participants reported whether they were successful in implementing their action plans and identified factors that either facilitated or hindered their goal to make changes outlined in their action plans. Despite the low response rate of program participants, the “action plan” (with follow up to determine degree of completion) appeared to stimulate effective behavioral changes in clinicians working with dementia patients and their family members. Seventy three percent of the respondents reported at least some level of success in implementing specific changes. Specific details about barriers to change and how to overcome them are discussed.

    Conclusions: Our results support that developing and writing action plans can be a useful tool to self- monitor behavioral change among trainees over time.