Key result
Screening for abdominal aortic aneurysm was offered or performed in only 30% of eligible patients within a VA primary care setting, identifying AAAs in 12.3% of those screened.
Why the study?
Are evidence-based screening guidelines for abdominal aortic aneurysms being implemented within a large VA primary health care system?
Cohort (n=279)
No
Are evidence-based screening guidelines for abdominal aortic aneurysms being implemented within a large VA primary health care system?
There is a low rate of implementation of AAA screening guidelines in this VA primary care setting, highlighting a need for performance metrics to improve screening rates.
Answers are grounded in this paper and cite their sources.
Low AAA screening rates in VA primary care highlight implementation gaps; leaves open whether performance metrics can improve guideline adherence.
BACKGROUND: Screening men aged 65 to 75 years who have ever smoked for abdominal aortic aneurysm (AAA) has been recommended to reduce AAA-related mortality. However, it is unknown whether the evidence-based recommendation has been implemented within primary care. OBJECTIVE: The aim of this study was to determine whether screening for AAA is being performed within a large Veterans Affairs (VA) primary health care system. METHODS: This was a retrospective cohort study examining AAA screening practices within the VA Connecticut Healthcare System. Any of the following imaging procedures were considered screening tests for AAA: abdominal ultrasound, computed tomography (CT) of the abdomen, CT colography, or magnetic resonance imaging of the abdomen. RESULTS: A total of 279 patients were included in the cohort: 83 (30%) were offered screening for AAA or had recent imaging performed that would have allowed for detection of an AAA. Seventy-three patients (26%) underwent AAA screening or had recent imaging of their abdomens, while 10 patients either refused imaging or were awaiting ultrasonographic screening at the time of this study. Of the 73 patients who had undergone screening or other abdominal imaging evaluations, 9 (12.3%) were found to have AAAs. CONCLUSIONS: There appears to be a low rate of screening for AAA within 1 primary care setting in a large VA health care system. If this finding is replicated within other VA primary health care settings, then the VA health care system should consider implementing a performance metric within primary care to improve AAA screening rates.
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Federman et al. (2009) conducted a cohort in Abdominal aortic aneurysm (n=279). Screening for abdominal aortic aneurysm was evaluated on Offered screening for AAA or had recent imaging performed. Screening for abdominal aortic aneurysm was offered or performed in only 30% of eligible patients within a VA primary care setting, identifying AAAs in 12.3% of those screened.
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