AHRQ Views: Blog posts from AHRQ leaders
AHRQ’s EvidenceNOW: Putting Heart Health into Practice
As we pass through another winter, I remember my father, who died in January a few years ago. He died days after his second heart attack. He suffered his first heart attack over 25 years earlier. I was a medical student at the time and his doctors explained that there was a good chance he would not survive more than a few years. Scared, perhaps for the first time in his life, he vowed to change. He threw himself into cardiac rehabilitation, took an aspirin every day, and worked with his doctors to get his blood pressure under control and manage his high cholesterol. We were all rewarded by his efforts. He was there when I graduated from medical school, when I was married, and when his grandson was born.
February is American Heart Month, a reminder that heart disease is still the leading cause of death for both men and women in the United States, and that there are actions we all can take to help prevent heart disease. As my father learned, in addition to eating well and being physically active, there are four cornerstones of heart health care that reduce the chance of having a heart attack or stroke—Aspirin use by individuals at high risk of having a heart attack or stroke, Blood pressure control for people with high blood pressure (also known as hypertension), Cholesterol management for people at risk for heart disease, and Smoking cessation.
Evidence about the value of the ABCS of heart health has been known for years. Yet according to some research, only about half of American adults are successfully controlling their high blood pressure, only half of American adults who could benefit are taking a statin medication to manage their cholesterol, and far too many adults who use tobacco say they don't get support from their doctors to help them quit.
To advance heart health in primary care, AHRQ launched its EvidenceNOW project in May 2015. EvidenceNOW funded seven regional research cooperatives to provide practice support services to 1,500 smaller primary care practices with 5,000 clinicians to build their capacity to improve heart health for 8 million patients across 12 States. The goal of AHRQ's EvidenceNOW initiative is to study how best to help smaller primary care practices, where most of us get our care, improve the rate at which they provide the ABCS. Specifically, EvidenceNOW aims to ensure that 70 percent or more of patients are getting the ABCS services they need.
We estimate that if the 1,500 practices participating in EvidenceNOW boosted their delivery of the ABCS by 10 percent, 250,000 more people would have their blood pressure controlled and 250,000 more people would be managing their cholesterol successfully. Clearly, the positive impact on health would be significant.
The support services provided by EvidenceNOW cooperatives, ranging from on-site coaching to health information technology support, are designed to help practices understand and apply evidence. This work serves as an example of how AHRQ fosters the development of learning health care systems, systems that use data and collaboration to constantly improve their care practices.
When the EvidenceNOW cooperatives started working with these small practices, they found that many practices were already delivering some of the ABCS to 70 percent or more of their patients, but that almost all practices had room for improvement. As shown in a new infographic, EvidenceNOW has established a baseline upon which we can monitor our progress.
Evaluations of EvidenceNOW are being conducted both nationally and by all seven of the regional cooperatives. These evaluations will identify which resources or interventions are most helpful in developing the capacity of primary care practices to learn and improve. The evaluation team will also study which practice support services and quality improvement strategies are most effective in improving the implementation of new medical evidence.
By helping smaller primary care practices learn about and implement the ABCS of heart health, EvidenceNOW is creating a blueprint of how to build a primary care system that delivers high-quality, patient-centered health care for everyone. At the same time, EvidenceNOW is supporting thousands of primary care professionals to help their patients improve their heart health.