Availability of Specialty Services for Cardiovascular Prevention Practice in the Southeastern United States.

dc.contributor.author

Ponir, Cynthia

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Annabathula, Rahul

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Caldarera, Trevor

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Penmetsa, Megha

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Seals, Austin

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Saha, Animita

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Moore, Justin B

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Bosworth, Hayden B

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Ip, Edward H

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Shapiro, Michael D

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Pokharel, Yashashwi

dc.date.accessioned

2024-01-02T19:47:57Z

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2024-01-02T19:47:57Z

dc.date.issued

2023-11

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Objectives

A comprehensive cardiovascular disease (CVD) prevention approach should address patients' medical, behavioral, and psychological issues. The aim of this study was to understand the clinician-reported availability of a pertinent CVD preventive workforce across various specialties using a survey study in the southeastern United States, an area with a disproportionate burden of CVD and commonly known as the Stroke Belt.

Methods

We surveyed physicians, advanced practice providers (APPs), and pharmacists in internal medicine, family medicine, endocrinology, and cardiology regarding available specialists in CVD preventive practice. We examined categorical variables using the χ2 test and continuous variables using the t test/analysis of variance.

Results

A total of 263 clinicians from 21 health systems participated (27.6% response rate, 91.5% from North Carolina). Most were women (54.5%) and physicians (72.5%) specializing in cardiology (43.6%) and working at academic centers (51.3%). Overall, most clinicians stated having adequate specialist services to manage hypertension (86.6%), diabetes mellitus (90.1%), and dyslipidemia (84%), with >50% stating having adequate specialist services for obesity, smoking cessation, diet/nutrition, and exercise counseling. Many reported working with an APP (69%) or a pharmacist (56.5%). Specialist services for exercise therapy, psychology, behavioral counseling, and preventive cardiology were less available. When examined across the four specialties, the majority reported having adequate specialist services for hypertension, diabetes mellitus, obesity, dyslipidemia, and diet/nutrition counseling. Providers from all four specialties were less likely to work with exercise therapists, psychologists, behavioral counselors, and preventive cardiologists.

Conclusions

A majority of providers expressed having adequate specialists for hypertension, diabetes mellitus, dyslipidemia, obesity, smoking cessation, diet/nutrition, and exercise counseling. Most worked together with APPs and pharmacists but less frequently with exercise therapists, psychologists, behavioral counselors, and preventive cardiologists. Further research should explore approaches to use and expand less commonly available specialists for optimal CVD preventive care.
dc.identifier

SMJ_230421

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0038-4348

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1541-8243

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https://hdl.handle.net/10161/29618

dc.language

eng

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Southern Medical Association

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Southern medical journal

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10.14423/smj.0000000000001617

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https://creativecommons.org/licenses/by-nc/4.0

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Humans

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Cardiovascular Diseases

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Hypertension

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Diabetes Mellitus

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Obesity

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Family Practice

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United States

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North Carolina

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Female

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Male

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Dyslipidemias

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Availability of Specialty Services for Cardiovascular Prevention Practice in the Southeastern United States.

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Journal article

duke.contributor.orcid

Bosworth, Hayden B|0000-0001-6188-9825

pubs.begin-page

848

pubs.end-page

856

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11

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Duke

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School of Medicine

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Medicine

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Psychiatry & Behavioral Sciences

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Medicine, General Internal Medicine

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Duke Cancer Institute

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Duke Clinical Research Institute

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Institutes and Provost's Academic Units

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Center for the Study of Aging and Human Development

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Initiatives

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Duke Science & Society

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Population Health Sciences

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Duke Innovation & Entrepreneurship

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Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences

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Duke - Margolis Center For Health Policy

pubs.publication-status

Published

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116

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