1011. Process of Care Patterns for Veterans with Peripheral Arterial Disease
Tracie C Collins, MD, MPH, Houston Center for Quality of Care and Utilization Studies and Baylor College of Medicine, RJ Beyth, Houston Center for Quality of Care and Utilization Studies and Baylor College of Medicine, NJ Petersen, Houston Center for Quality of Care and Utilization Studies and Baylor College of Medicine, M Suarez-Almazor, Houston Center for Quality of Care and Utilization Studies and Baylor College of Medicine, R Bush, Houston Center for Quality of Care and Utilization Studies and Baylor College of Medicine, CA Ashton, Houston Center for Quality of Care and Utilization Studies and Baylor College of Medicine

Objectives: We sought to determine clinicians’ attempts to control atherosclerotic risk factors for patients with peripheral arterial disease (PAD).

Methods: Using a retrospective cohort design, we performed chart reviews of patients diagnosed with PAD (ankle-brachial index < 0.9 in at least one leg) by a vascular laboratory visit at the HVAMC between 1/1/95 and 12/31/98. Trained nurse abstractors reviewed charts to capture a clinician’s documentation of and management plan for each atherosclerotic risk factor; data extraction dates were 1/1/92 – 12/31/01.

Results: To date, we performed chart reviews for 368 of 816 patients with PAD. Among the 368 patients (mean age 64.1 ± 9.8 years), 253 had a documented history of smoking but only 146 (57.7%) had a documented plan for smoking cessation; 154 had a history of diabetes mellitus but only 66 (42.8%) had a plan for treatment; 277 had a history of hypertension but only 135 (48.7%) had a plan for treatment; 159 had a history of dyslipidemia but only 86 (54.1%) had a plan for treatment. Only 293 patients had a recognized diagnosis of PAD and, of these patients, only 126 (43.0%) had a plan for treatment.

Conclusions: Fewer than 60% of patients with PAD have a documented plan for the control of smoking, diabetes mellitus, hypertension, or dyslipidemia. Fewer than 50% of patients with a recognized diagnosis of PAD had a documented plan for the treatment of their disease.

Impact: Ultimately, we plan to determine the association between intended process of care and actual risk factor control in veterans with PAD.