Study Recommends Education Level Be Added to CHD Treatment Guidelines
Finding that patients who have not finished high school have a 2.4 percent higher risk of dying of coronary heart disease (CHD) than those with more schooling, Fiscella and colleagues suggest that educational level of less that 12 years should be incorporated into the current CHD treatment guidelines. The findings were drawn from a prospective cohort study of 6,479 adults aged 25 to 74 years who participated in the National Health and Nutrition Examination Survey and for whom ascertainment of risk factors and 10-year status was available. The authors point out that the risk associated with low education level is comparable in magnitude to many of the traditional risk factors, including cholesterol level, smoking status, sex and age, which are included in the current treatment guidelines. The authors suggest that use of low education level to identify persons at higher risk of CHD, who are not otherwise identifiable under current guidelines, may facilitate progress toward individualized treatment and the elimination of socioeconomic disparities in health.
Should Years of Schooling Be Used to Guide Treatment of Coronary Risk Factors?
By Kevin Fiscella, M.D., M.P.H., et al

Expensive New Medications Significantly Increase Drug Expenditures in the North Carolina Medicaid Program
An increase in the number of prescriptions for new and more expensive medications resulted in a significant rise in drug costs in the North Carolina Medicaid program. Analyzing claims for more than 1,204,000 North Carolina Medicaid enrollees between 1998 and 2000, researchers found that prescription drug coverage costs rose 22.8 percent annually during the study period, from $503 per person per year in 1998 to $759 in 2000. The average number of prescriptions filled per person per year also increased from 13 in 1998 to 15.5 in 2000. The authors point out that increased pres
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Contact: Angela Lower
alower@aafp.org
913-906-6253
American Academy of Family Physicians
5-Oct-2004

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