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

Table 4 Patient prescription history 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)
Patient prescription history
Patient previously had prescription for indicated drug			<.0001			<.0001
No	6761	(10.9)		2898	(18.5)
Yes	4827	(16.5)		6989	(14.8)
Patient has active^dprescription for insulin
No	8682	(14.7)	<.0001	7075	(18.7)	<.0001
Yes	2906	(8.7)		2812	(8.7)
Patient has active^dprescription for non-insulin anti-hyperglycemic meds			<.0001			<.0001
No	5639	(15.5)		4914	(18.5)
Yes	5949	(11.1)		4973	(13.2)
Patient has active^dprescription for narcotic			<.0001			<.0001
No	9422	(14.7)		7805	(18.1)
Yes	2166	(6.7)		2082	(7.3)
Patient has active^dprescription for CVD meds			<.0001			<.0001
No	8374	(15.4)		6553	(19.5)
Yes	3214	(7.6)		3334	(8.7)
Patient has active^dprescription for psychotherapeutic meds			<.0001			<.0001
No	7541	(16.1)		5996	(20.4)
Yes	4047	(7.9)		3891	(8.8)

Abbreviations: ACEI angiotensin-converting enzyme inhibitor, ARB angiotensin II receptor blockers, CVD cardiovascular disease; Rx referral
^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
^dRx ordered < date of the visit and end date of order is null or > date of visit

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