Analyses of compliance to evidence based guidelines in the areas of hyperlipidemia, men's preventative health, and stroke/heart disease in New Jersey family practices

10 ACKNOWLEDGEMENTS.12 LIST OF TABLES.14 LIST OF FIGURES. 14 CHAPTER 1: INTRODUCTION.22 1.1 Background of the problem.22 1.2 Statement of the problem.22 1.3 Objectives of the study.23 1.4 Significance of the study.23 CHAPTER 2: REVIEW OF LITERATURE.25 2.1 On Related Literature.25 2.1.1 On Evidence Based Medicine.25 2.1.2 On the Primary Care Crisis.26 2.1.3 On Raising Provider Awareness to Compliance Issues.28 2.1.4 The Importance of Physician Engagement in Improving Quality of Care.28 2.1. 5 On Engaging Physicians to look at their quality of practice.34 2.1. 6 Barriers to Improving Quality of Care.36 2.2 On Methods.38 2.2.1 On QA/QI.38 2.2.2 On Review of Case Studies.48 2.2.3 On PDSA.48 2.2.4 On Measuring Qualitative Success of Quality Improvement Initiative.49 2.2.4.1 On James Prochaska’s Transtheoretical Model of Behavioral Change.49 2.2. 5 On Measuring Quantitative Success of Quality Improvement Initiative: Methods of Statistical Analysis.50 2.2. 5.1 On Univariate Analysis.50 4 2.2. 5.2 On Chi-Squared Analysis.51 2.2. 5.3 On Two-Sample T-test.53 2.3 Conclusion of the Literature Review.55 2.4 Research Questions and Hypotheses.55 CHAPTER 3: RESEARCH METHOD AND DESIGN.57 3.1 Objectives.57 3.2 Data Source.57 3.3 Research Design.58 3.4 Data Elements.59 3.5 Sample Population.62 3.6 Measurement of Exposure and Outcome Variables.63 3.7 Statistical Analysis.64 3.8 Data Handling and Pre-Processing.64 CHAPTER 4: RESULTS.66 4.1 On Current Compliance to Evidence Based Practice.66 4.1.1 Hyperlipidemia.66 4.1.1.1 Sample Characteristics for Patients Screened for Appropriate Treatment of Hyperlipidemia—Academic year 2015-16.66 4.1.1.2 Analysis of patients that were screened for appropriate treatment of hyperlipidemia (Academic year 2015-16). 73 4.1.1.2.1 Did patients fast >12 hours before lipid panel? 73 4.1.1.2.2 Were patients currently receiving treatment for hypertension? 74 4.1.1.2.3 Analysis of Category A, B, C, and D patients.74 4.1.1.2.3.1 How often were Category A patients treated appropriately? 74 4.1.1.2.3.2 How often were Category B patients treated appropriately? 75 4.1.1.2.3.3 How often were Category C patients treated appropriately? 76 4.1.1.2.3.4 How often were Category D patients treated appropriately? 77 5 4.1.2 Men’s Preventative Health.78 4.1.2.1 Sample Characteristics for Population of Patients selected for study on appropriate screening of Men’s Preventative health—Academic year 2015-16.78 4.1.2.2 Analysis of patients that were screened for appropriate Male preventative screening.81 4.1.2.2.1 How often were men appropriately screened for colorectal cancer? 81 4.1.2.2.2 How often were men screened for depression when staff assisted depression care supports were in place? 81 4.1.2.2.3 Have male patients been given TDAP vaccine after age 19? 82 4.1.2.2.4 Have male patients between ages 21-26 received 3 doses of the HPV vaccine? 84 4.1.2.2. 5 Have eligible male patients been counseled on smoking cessation? 85 4.1.2.2. 6 Have male patients been screened appropriately for AAA? 86 4.1.2.2. 7 Are male patients on aspirin being appropriately screened for GI bleeding? 87 4.1.2.2. 8 Are male patients being appropriately screened for high blood pressure? 88 4.1.2.2. 9 How often are male patients being screened appropriately for carotid artery stenosis? 89 4.1.3 Prevention of Stroke/Heart Disease.91 4.1.3.1 Sample Characteristics for Population of Patients selected for study of Appropriate Stroke/Heart Disease Prevention Measures— Academic year 2015-16.91 4.1.3.2 Analysis of patients that were screened for appropriate measures for prevention of Heart disease/stroke—Academic year 201516.97 4.1.1.3.1 Is the patient on aspirin or any other antithrombotic? 97 4.1.1.3.2 Has the patient’s smoking status been updated within the last year? 99