RESUMO
Objective: To assess the impact of a multi-pronged educational approach on the knowledge, attitudes, and behaviors regarding Familial Hypercholesterolemia (FH) management at a large academic medical center with the aim of empowering primary care clinicians (PCC) to diagnose and treat FH. Methods: A comprehensive educational program for PCCs on FH management was developed and piloted from July 2022 to March 2024. Components of our intervention included: 1. Implementation of a novel clinical decision support tool in the electronic medical record for FH management, 2. Development and dissemination of an interactive educational website focused on FH and its management, 3. Delivery of virtual instructional sessions to increase awareness of the tool, provide education on its use, and obtain support from institutional leadership, and 4. Direct outreach to a pilot subset of PCCs whose patients had been detected using the validated FIND FH® machine learning algorithm. Participating clinicians were surveyed at baseline before the intervention and after the educational session. Results: 70 PCC consented to participate in the study with a survey completion rate of 79 % (n = 55) and 42 % (n = 23) for the baseline and follow-up surveys, respectively. Objective PCC knowledge scores improved from 40 to 65 % of responders correctly responding to at least 2/3rds of survey questions. Despite the fact that 87 % identified PCC's as most effective for early detection of FH, 100 % of PCCs who received direct outreach chose to defer care to an outpatient cardiologist over pursuing workup in the primary care setting. Conclusion: Empowering PCCs in management of FH serves as a key strategy in addressing this underdiagnosed and undertreated potentially life-threatening condition. A systems-based approach to addressing these aims may include leveraging EMR-based clinical decision support models and cross-disciplinary educational partnerships with medical specialists.
RESUMO
Two-thirds of the US population is either overweight or obese. Obesity is one of the major drivers of preventable diseases and health care costs. In the US, current estimates for these costs range from $147 to $210 billion per year. Obesity is a multifactorial disease: genetics, lifestyle choices, metabolism, and diet. Low-fat diets have been suggested as the key to weight management. However, over the past 30 years, the calories from fat in people's diets have gone down, but obesity rates keep climbing. Evidence suggests that diets high in added sugar promote the development of obesity. However, the impact of sugar consumption on weight gain and body fat accumulation remains a controversial topic. Therefore, the aim of this review is to provide basic framework information about the prevalence of obesity and sugar consumption in the US over the last five decades. We also review the process by which sugar is converted to fat and stored in the human body. The relationship between sugar consumption and obesity was analyzed using United States Department of Agriculture (USDA) Sugar and Sweetener Outlook data, and obesity prevalence was analyzed using data from the Centers for Disease Control and Prevention (CDC). The analysis revealed a reduction in sugar consumption concurrent with a slowing down of the annual rate of increase of obesity. However, although the data show that the sugar consumption trend is going in the right direction (declining), the US population still consumes more than 300% of the recommended daily amount of added sugar.