Cardiovascular care guideline implementation in community health centers in Oregon: a mixed-methods analysis of real-world barriers and challenges

Table 1 Encounter characteristics associated with statin and ACEI/ARB prescribing at in-person office visits at 10 community health centers in Oregon where the medication(s) was/were clinically indicated^a, June 2011 to May 2014

	Office visits^b where a statin indicated			Office visits^b where an ACEI/ARB was indicated
	Number of encounters^c	% with an statin Rx < = 2 days	p-value	Number of encounters^c	% with an ACEI/ARBs Rx < = 2 days	p-value
Total	11588	(13.2)		9887	(15.8)
Encounters
Diabetes encounter^d			<.0001			<.0001
# encounters for patient in last year with same provider			<.0001			<.0001
0	3114	(14.3)		2669	(21.9)
1-3	4345	(16.8)		3455	(18.4)
> = 4	4129	(8.7)		3763	(9.2)
# encounters for patient in last year at same clinic			<.0001			<.0001
0	1186	(22.9)		1091	(37.2)
1-3	4114	(18.4)		3202	(20.5)
> = 4	6288	(8.0)		5594	(9.0)
Diabetes encounter^d			<.0001			<.0001
No	5082	(6.2)		4388	(8.7)
Ye	6506	(18.7)		5499	(21.5)
Encounter provider type			0.0003			<.0001
Physician/Resident	6810	(12.3)		6256	(13.6)
PA/NP	4778	(14.6)		3631	(19.6)
Encounter provider was PCP?			<.0001			<.0001
No	2092	(7.1)		1672	(10.0)
Yes	9257	(14.5)		7988	(16.8)
Missing/Unknown	239	(19.2)		227	(25.6)
Nurse touched chart in encounter?			<.0001			0.0007
No	8383	(12.3)		7190	(15.1)
Yes	3205	(15.6)		2697	(17.9)
# non-study alerts fired at encounter			0.5615			0.0046
0	2076	(13.0)		1681	(17.3)
1-2	6376	(13.0)		5650	(14.8)
> = 3	3136	(13.8)		2556	(17.2)

Abbreviations: ACEI angiotensin-converting enzyme inhibitor, ARB angiotensin II receptor blockers; PA Physician’s Assistant, Pcp primary care provider assigned to patient, NP Nurse Practitioner
^aPoint-of-care alert for specified drug class fired at the visit
^bOffice visits defined as in-person encounters at a study clinic where the provider was a MD, PA, NP, or resident, and the encounter Evaluation & Management CPT code was in: 99201-99205; 99212-99215; 99243; 99385-99387; 99395-99397
^cVisit counts are not mutually exclusive, e.g., if both types of BPA fired at a visit, the visit is counted in both the statin and ACEI/ARB columns. p-value from chi square test for independence between characteristic and outcome of Rx < = 2 days
^dDiabetes encounter = DM listed as chief complaint or DM listed as the primary Dx for visit, or DM was the first Dx associated with visit

ISSN: 1472-6963