Multiple interventions of academic detailing and desk chart reminders Agrimon, Oryzati H. Lavina, Shiela Alba, Ma. Elinore M. Espallardo, Noel text monographic eng

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Background: Evidences have shown that obesity aggravates hypertension, dyslipidemia, and diabetes, such that the management of obesity should be implemented in the context of these other risk factors. Obesity aggravates hypertension and diabetes type 2, making it necessary to screen for obesity in these conditions as well. Objective: This study aimed to examine the effects of academic detailing and desk chart reminders on the overall appropriateness of screening for obesity among patients presenting with hypertension and type 2 diabetes mellitus. Setting: The Family Medicine Clinic of University of Philippines Manila-Philippine General Hospital (FMC UPM-PGH) was the chosen study site. Subjects: All residents of the family and community medicine program were included. Design: This is a before and after intervention study. Intervention: Academic detailing; individualized-feedback & flyer, and desk chart reminders regarding the screening criteria for obesity were utilized simultaneously to enhance the appropriateness of screening for obesity among patients presenting with hypertension and type 2 diabetes mellitus as measured by a chart audit. The target standard of appropriateness was arbitrarily set at 90 percent. Outcome Measures: A total of 100 patient charts (50 at baseline and 50 after the intervention) were reviewed. Audit criteria were established using the Clinical Practice Guidelines on the Diagnosing and Treating Obesity in Family Practice developed by the Family Medicine Research Group UPM-PGH, consisting of criteria on history taking, physical examination, laboratory procedure, and therapeutic advice. Main outcome measure was appropriateness of screening represented by performance level expressed in terms of proportions of those who followed the criterion set. Results: The overall appropriateness of screening improved. However, only criterion of therapeutic advice which achieved and even exceeded the target standard of appropriateness, i.e. an increase to 92 percent at p value of .000. Another criterion which also showed statistical significance was appropriateness of physical examination, which showed an increase of 32 percent at p=.0018. The criteria of history taking and laboratory procedure showed an increase of 6 percent at p=.1718 and 10 percent at p=.1862, respectively. Conclusion: The utilization of multiple interventions of academic detailing (consisting of giving individualized-feedback and flyers) and chart reminder of the screening criteria for obesity improved the overall appropriateness of screening as documented in the patients charts. Oryzati H. Agrimon [and three others] The Filipino Family Physician, 2003 41 ( 3 ) pages 103-110 Quality Improvement Hypertension Obesity Diabetes Mellitus, Type 2 210413 20210413141953.0 D0001J000453