Study: Multifaceted healthcare works well

WINSTON-SALEM, N.C., April 23 (UPI) -- A U.S. study suggests physicians using a variety of tools, including a personal digital assistant, provide better cholesterol care than do other physicians.

The Wake Forest University study tracked adherence to clinical guidelines at 61 primary care practices. The study aimed to improve treatment of high cholesterol by having physicians use a PDA to assess a patient's risk of heart disease and recommend treatment.

Doctors also received copies of the National Cholesterol Education Program cholesterol guideline as well as presentations on treating high cholesterol.

"We wanted to know if we could improve guideline adherence with this multifaceted strategy," said Assistant Professor Alain Bertoni, who led the study. "When you look at previous quality improvement efforts, it appears that single strategies don't work that well."

For the study, a decision-making tool was programmed into PDAs. It calculated the patient's risk of heart disease and then considered LDL-cholesterol levels before recommending a drug dosage or no treatment at all.

In the group using PDAs, the level of appropriate treatment decisions remained relatively stable, while the incidence of over-treatment decreased. In contrast, in the group of doctors not using PDAs, the percentage of cases receiving appropriate cholesterol management decreased by nearly nine percent and the occurrence of over-treatment increased from 4.2 percent to 6.4 percent.

The research appears in the April 13 issue of the journal Archives of Internal Medicine.