Overcoming Barriers to Abdominal Aortic Aneurysm AAA Screening

Overcoming Barriers to Abdominal Aortic Aneurysm (AAA) Screening in Primary Care Isioma Okwumabua, MD, Kanyan Xiao, MD, MS, Folashade Omole, MD, FAAFP, Charles M. Sow, MD, MSCR Department of Family Medicine, Morehouse School of Medicine, Atlanta, GA Introduction Objectives The incidence and prevalence of abdominal aortic aneurysm (AAA) is increasing with an aging population. Rupture of AAA accounts for up to 30, 000 deaths per year in the US, i. e. 80% mortality rate; therefore early detection is paramount. 1. Assess physician knowledge and awareness in AAA screening guidelines and management. Patients with AAA are usually asymptomatic, and physical examination lacks sensitivity in detection. Primary care physicians play a critical role in screening and improving mortality. 3. Identify major barriers to AAA screening in primary care In our study, we investigated the knowledge, attitude and practice of AAA screening in primary care. Abdominal Aortic Aneurysm Conclusion 2. Assess current practice among residents and faculty regarding AAA screening 4. Improve screening and mortality of AAA Methods More faculty than residents refer patients for AAA screening Faculty Residents 70 ® Improving awareness and knowledge among primary care physicians will increase AAA screening in the appropriate patient population recommended by USPSTF and improve outcome of AAA. 60 50 40 30 20 10 ® A 15 item questionnaire using survey monkey, was developed to assess awareness, knowledge and management of AAA. ® The questionnaire was sent out to residents and faculty of MSM FM residency program; as well as other FM programs on the Association of Family Medicine Residency directors (AFMRD) list serve. 0 Always Sometimes Rarely Never Awareness, knowledge and patient compliance were the identified barriers to AAA screening ® In addition, implementing physician reminders might also improve awareness for AAA screening, although previous studies have suggested that physician reminders alone is not sufficient. References 1. Lederie FA , Simel DL. The rational clinical examination. Does this patient have abdominal aortic aneurysm? JAMA 1999; 281: 77 -82 Results Faculty/Resident respondent ratio 2. Eaton J , Reed D. Effect of visit length and clinical decision support tool on AAA screening rates in primary care. J Eval Clin Prac 2011 Jan 6 Resident Faculty ® Our study indicates that awareness is the most important barrier for AAA screening, followed by knowledge. 3. Reardon RF, Cook T, Plummer D. Abdominal aortic aneurysm, Emergency Ultrasound, 2 nd ed. New York, NY: Mc. Graw-Hill; 2008: 149 -168 All Other Responses 121 of 191 respondents were residents Acknowledgement Reminders by prompting might enhance referral for AAA screening ® Morehouse Family Medicine Faculty and Residents ® All Faculty and Residents who participated via AFMRD Assessing knowledge of AAA screening ® Gregory Strayhorn, MD, Ph. D ® Ashley Davis ® Logan Ayaba