Comparison of Methods to Improve Abdominal Aortic Aneurysm (AAA) Screening Rates in the Primary Care Setting.
Condition: Abdominal Aortic Aneurysm
MeSH terms: Aneurysm; Aortic Aneurysm; Aortic Aneurysm, Abdominal
Study type: Observational

Summary: 
      Standard of care dictates that eligible patients should receive an abdominal aortic aneurysm
      (AAA) screening ultrasound. At present, different military primary care physicians utilize
      different methods at their discretion to ensure their patients get screened-telephone
      contact; mail-out reminders; referring patients for ultrasound directly from an office visit;
      as well as other methods-which we will refer to as "usual care". The purpose of this study is
      to improve screening rates for AAA and determine what notification methods are best at
      improving screening rates.
    

Detailed description: 
      Approximately 1700 male patients (DoD beneficiaries) between the ages of 65-75 will be
      selected from their medical records. The information on the attached abstracted data sheet
      will be collected. As part of standard patient care operations, the Family Medicine and
      Internal Medicine Departments will inform patients on the need to receive a AAA screening
      ultrasound, based on their primary care manager's (PCM) preference for clinical notification:

        1. Nurse initiated Telephone Consult (T-Con) (see attached)

        2. Mail-0ut Letter to the patient (see attached)

        3. Provider, Nurse and Technician Education with point-of-care patient referrals , Exam
           Room Flyer

        4. Control group (i.e. usual care)

      The Provider, Nurse and Technician Education will consist of a presentation given by the
      Principal Investigator (see attached PowerPoint) to the Family Medicine and Internal Medicine
      clinic staff and the posting of Exam Room Flyers in each Family Medicine and Internal
      Medicine exam room to prompt and encourage patient referrals for a AAA screening ultrasound.

      Information requested on the attached abstracted data sheet will be used for initial
      identification of patients that should have a AAA screening ultrasound and again 3-4 months
      later to see if these same individuals received the procedure. All informational data sets
      will be totally de-identified by the Research Coordinator, Nellis Air Force Base, prior to
      releasing to the Principle Investigator.

      The data will then be analyzed by Dr. Anneke Bush (WHMC statistician) and the results will be
      provided to the Principal Investigator for analysis.
    

Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        We will recruit approximately 1700 males (DoD beneficiaries) between the ages of 65-75 from
        their existing medical diagnostic records. There will be no special populations included.
        Some respondents may be patients of the PI however; the data sets received by the PI will
        be anonymous and will not be linked directly to the subjects.
      
Keywords: abdominal aortic aneurysm