National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Blood Pressure (1)
- Blood Thinners (2)
- Cardiovascular Conditions (11)
- Case Study (2)
- Children/Adolescents (2)
- Clinician-Patient Communication (1)
- Communication (1)
- Comparative Effectiveness (1)
- Critical Care (1)
- Evidence-Based Practice (10)
- (-) Guidelines (16)
- Health Information Technology (HIT) (1)
- (-) Heart Disease and Health (16)
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- Implementation (1)
- Lifestyle Changes (1)
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- Medication (5)
- Nutrition (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (3)
- Practice Patterns (1)
- Prevention (6)
- Primary Care (2)
- Registries (3)
- Risk (1)
- Screening (2)
- Shared Decision Making (2)
- Social Media (1)
- Stroke (1)
- U.S. Preventive Services Task Force (USPSTF) (4)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 16 of 16 Research Studies DisplayedSchroeder MC, Chapman CG, Chrischilles EA
Generating practice-based evidence in the use of guideline-recommended combination therapy for secondary prevention of acute myocardial infarction.
This study’s goal was to determine if variation in real-world practice of guideline-recommended combination therapy for secondary prevention of acute myocardial infarction (AMI) reflects poor quality-of-care or a balance of outcome tradeoffs among patients. Medicare fee-for-service beneficiaries hospitalized 2007-2008 for AMI were included. Treatment within 30-days post-discharge was grouped into one of eight possible combinations for the three drug classes: beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers, and statins. Outcomes looked at included one-year overall survival, one-year cardiovascular-event-free survival, and 90-day adverse events. Results were found that each drug combination was observed in the final sample (N = 124,695), with 35.7% having all three, and 13.5% having none. There were both treatment benefits and harms in patients with AMIs with higher rates of guideline-recommended treatment.
AHRQ-funded; HS018381.
Citation: Schroeder MC, Chapman CG, Chrischilles EA .
Generating practice-based evidence in the use of guideline-recommended combination therapy for secondary prevention of acute myocardial infarction.
Pharmacy 2022 Nov 3;10(6). doi: 10.3390/pharmacy10060147..
Keywords: Evidence-Based Practice, Guidelines, Heart Disease and Health, Cardiovascular Conditions, Comparative Effectiveness, Patient-Centered Outcomes Research, Prevention
Mills J, O'Dowd N
AHRQ Author: Mills J
Healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
This “Putting Prevention into Practice: An Evidence Based Approach” paper is a case study with questions and answers related to healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
AHRQ-authored.
Citation: Mills J, O'Dowd N .
Healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
Am Fam Physician 2021 Oct 1;104(4):411-12..
Keywords: U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Cardiovascular Conditions, Prevention, Lifestyle Changes, Risk, Evidence-Based Practice, Guidelines, Case Study
Nguyen AM, Cuthel AM, Rogers ES
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
This study called HealthyHearts NYC was a stepped wedge randomized control trial that tested the effectiveness of practice facilitation in small primary care practices in adopting cardiovascular disease guidelines. The practice-level benchmark desired was having 70% or greater of hypertensive patients having controlled blood pressure. A mixed methods multiple-case study design was used and implemented at 6 small practices. The investigator’s first key finding was that the high-performing and improved practices in their study looked and acted similarly during the intervention implementation. Three key attributes of these practices were found to be: 1) advanced use of electronic health records; 2) dedicated resources and commitment to quality improvement; and 3) an actively engaged lead clinician and office manager.
AHRQ-funded; HS023922.
Citation: Nguyen AM, Cuthel AM, Rogers ES .
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
J Prim Care Community Health 2020 Jan-Dec;11. doi: 10.1177/2150132720984411..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Guidelines, Implementation
Gregory EF, Miller JM, Wasserman RC
Adherence to pediatric universal cholesterol testing guidelines across body mass index categories: A CER(2) cohort study.
This study asks whether, and to what extent, universal cholesterol testing has been adopted since the 2011 guideline. Findings showed that cholesterol testing by age 12 years increased between 2011 and 2016; children with elevated BMI were more likely to complete testing for all birth cohorts. However, testing among children with normal BMI has become increasingly prevalent, suggesting a shift toward universal cholesterol testing in pediatrics since the 2011 recommendation.
AHRQ-funded; HS021645.
Citation: Gregory EF, Miller JM, Wasserman RC .
Adherence to pediatric universal cholesterol testing guidelines across body mass index categories: A CER(2) cohort study.
Circ Cardiovasc Qual Outcomes 2020 Aug;13(8):e006519. doi: 10.1161/circoutcomes.119.006519..
Keywords: Children/Adolescents, Heart Disease and Health, Guidelines, Practice Patterns, Evidence-Based Practice
Brand-McCarthy SR, Delaney RK, Noseworthy PA
Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines.
This paper discusses the need for shared decision making (SDM) in atrial fibrillation (AF) patients not just at the beginning of treatment but throughout during ongoing care. Use of SDM can help with patient adherence to recommended anticoagulation treatment regimens and lifestyle changes. It can help build a strong partnership between clinician and patient.
AHRQ-funded; HS026379.
Citation: Brand-McCarthy SR, Delaney RK, Noseworthy PA .
Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines.
Circ Cardiovasc Qual Outcomes 2020 Mar;13(3):e006080. doi: 10.1161/circoutcomes.119.006080..
Keywords: Shared Decision Making, Stroke, Heart Disease and Health, Cardiovascular Conditions, Prevention, Guidelines, Blood Thinners, Medication, Clinician-Patient Communication, Communication
Kelly JP, DeVore AD, Wu J
Rhythm control versus rate control in patients with atrial fibrillation and heart failure with preserved ejection fraction: insights from get with the guidelines-heart failure.
Researchers analyzed the Get With The Guidelines - Heart Failure (GWTG-HF) registry linked to Medicare claims data to describe current treatments for rate versus rhythm control and subsequent outcomes in patients with heart failure with preserved ejection fraction and atrial fibrillation. They found that rhythm control in patients aged 65 and older with heart failure with preserved ejection fraction and AF was associated with a lower risk of one-year all-cause mortality. They recommended future prospective randomized studies to explore this potential benefit.
AHRQ-funded; HS021092.
Citation: Kelly JP, DeVore AD, Wu J .
Rhythm control versus rate control in patients with atrial fibrillation and heart failure with preserved ejection fraction: insights from get with the guidelines-heart failure.
J Am Heart Assoc 2019 Dec 17;8(24):e011560. doi: 10.1161/jaha.118.011560.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Guidelines, Evidence-Based Practice, Registries, Patient-Centered Outcomes Research
Tracer H, Welch R
AHRQ Author: Tracer H
Screening for atrial fibrillation with electrocardiography.
This case study describes a 67-year-old woman with hypertension who neither drinks nor smokes and is moderately physically active. Her brother has recently been diagnosed with atrial fibrillation and she requests an electrocardiograph (ECG) to be screened herself for this condition. The case study questions are based on USPSTF recommendations for screening for atrial fibrillation with electrocardiography.
AHRQ-authored.
Citation: Tracer H, Welch R .
Screening for atrial fibrillation with electrocardiography.
Am Fam Physician 2019 Mar 15;99(6):383-84..
Keywords: U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Cardiovascular Conditions, Screening, Prevention, Evidence-Based Practice, Case Study, Guidelines
Jonas DE, Kahwati LC, Yun JDY
Screening for atrial fibrillation with electrocardiography: evidence report and systematic review for the US Preventive Services Task Force.
The objective of this study was to review the evidence on screening for nonvalvular atrial fibrillation with electrocardiography (ECG) and stroke prevention treatment in asymptomatic adults 65 years or older to inform the US Preventive Services Task Force. The authors concluded that although screening with ECG can detect previously unknown cases of atrial fibrillation, it has not been shown to detect more cases than screening focused on pulse palpation.
AHRQ-funded; 290201500011I.
Citation: Jonas DE, Kahwati LC, Yun JDY .
Screening for atrial fibrillation with electrocardiography: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2018 Aug 7;320(5):485-98. doi: 10.1001/jama.2018.4190..
Keywords: U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Cardiovascular Conditions, Screening, Evidence-Based Practice, Guidelines, Prevention
Egan BM, Li J, Davis RA
Differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
The US Preventive Services Task Force cholesterol guideline recommended statins for fewer adults than the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline by setting a higher 10-year atherosclerotic cardiovascular disease threshold and requiring concomitant diabetes mellitus, hypertension, dyslipidemia, or cigarette smoking. The 2017 ACC/AHA hypertension guideline lowered the hypertension threshold, increasing 2016 guideline statin-eligible adults. This article discusses differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
AHRQ-funded; P30 HS021667.
Citation: Egan BM, Li J, Davis RA .
Differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
J Clin Hypertens 2018 Jun;20(6):991-1000. doi: 10.1111/jch.13314..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Evidence-Based Practice, Guidelines, Blood Pressure, Medication, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Barlow SE, Turer CB
Lipid screening and treatment practices conflict with conflicting recommendations: where do we go from here?
This article comments on a 2017 study by de Ferranti, et al., published in the Journal of Pediatrics, which reported results from a survey of US pediatricians’ knowledge and implementation of child and adolescent cholesterol screening and treatment guidelines.
AHRQ-funded; HS022418.
Citation: Barlow SE, Turer CB .
Lipid screening and treatment practices conflict with conflicting recommendations: where do we go from here?
J Pediatr 2017 Jun;185:16-18. doi: 10.1016/j.jpeds.2017.02.041..
Keywords: Children/Adolescents, Heart Disease and Health, Shared Decision Making, Guidelines
Parikh KS, Lippmann SJ, Greiner M
Scope of sacubitril/valsartan eligibility after heart failure hospitalization: findings from the GWTG-HF Registry (Get With The Guidelines-Heart Failure).
Researchers used the Get With The Guidelines-Heart Failure (GWTG-HF) registry to characterize patients’ eligibility and potential barriers for sacubitril/valsartan initiation. The GWTG-HF registry was established by the American Heart Association to improve adherence to quality of care guidelines for patients hospitalized with heart failure. The FDA has approved sacubitril/valsartan for patients with heart failure with reduced ejection fraction (HFrEF); however, FDA labeling is broader than the trial entry criteria, and the scope of potential sacubitril/valsartan use in HFrEF is not well understood. Findings suggest that discharge from hospitalization from acute heart failure may be an opportunity for re-evaluating medications, including potentially switching the patient from ACEI/ARB, or starting sacubitril/valsartan.
AHRQ-funded; HS021092.
Citation: Parikh KS, Lippmann SJ, Greiner M .
Scope of sacubitril/valsartan eligibility after heart failure hospitalization: findings from the GWTG-HF Registry (Get With The Guidelines-Heart Failure).
Circulation 2017 May 23;135(21):2077-80. doi: 10.1161/circulationaha.117.027773..
Keywords: Cardiovascular Conditions, Guidelines, Heart Disease and Health, Hospitalization, Medication, Registries
Dhruva SS, Desai NR, Karaca-Mandic P
Medicare formulary changes after the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline.
This letter describes a study which examined the use of statins and non-statin medications at Medicare formularies before and after the 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guideline was released. The study found that while many formularies did restrict nonstatin medications as per the new guidelines, many others did not.
AHRQ-funded; HS023000.
Citation: Dhruva SS, Desai NR, Karaca-Mandic P .
Medicare formulary changes after the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline.
J Am Coll Cardiol 2017 Jan 17;69(2):244-46. doi: 10.1016/j.jacc.2016.10.053..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Guidelines, Medicare, Medication
Hand RK, Kenne D, Wolfram TM
Assessing the viability of social media for disseminating evidence-based nutrition practice guideline through content analysis of twitter messages and health professional interviews: an observational study.
This study explored the potential for social media dissemination of the Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guideline (EBNPG) for Heart Failure (HF). ). It found that interview participants believed that social media was a useful way to gather professional information. They did not believe that social media was useful for communicating with patients.
AHRQ-funded; HS021953.
Citation: Hand RK, Kenne D, Wolfram TM .
Assessing the viability of social media for disseminating evidence-based nutrition practice guideline through content analysis of twitter messages and health professional interviews: an observational study.
J Med Internet Res 2016 Nov 15;18(11):e295. doi: 10.2196/jmir.5811.
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Keywords: Social Media, Evidence-Based Practice, Guidelines, Heart Disease and Health, Nutrition
Bergethon KE, Ju C, DeVore AD
Trends in 30-day readmission rates for patients hospitalized with heart failure: findings from the Get With The Guidelines-Heart Failure Registry.
The researchers analyzed data from the Heart Failure registry linked to Medicare claims between 2009 and 2012 to describe trends and relative reduction of rates of 30-day all-cause readmission among patients with heart failure. They concluded that although there has been slight improvement in 30-day all-cause readmission rates during the past 4 years in patients with heart failure, few hospitals have seen large success.
AHRQ-funded; HS021092.
Citation: Bergethon KE, Ju C, DeVore AD .
Trends in 30-day readmission rates for patients hospitalized with heart failure: findings from the Get With The Guidelines-Heart Failure Registry.
Circ Heart Fail 2016 Jun;9(6). doi: 10.1161/circheartfailure.115.002594.
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Keywords: Guidelines, Heart Disease and Health, Hospital Readmissions, Hospitalization, Registries
O'Brien EC, Kim S, Hess PL
Effect of the 2014 atrial fibrillation guideline revisions on the proportion of patients recommended for oral anticoagulation.
Researchers assessed the potential effect of a new guideline for atrial fibrillation (AF) by comparing the proportion of patients with AF recommended for oral anticoagulation (OAC) under the 2011 and 2014 guidelines. They found that two-thirds of patients with AF who were previously not recommended for OAC are newly recommended under the 2014 guideline. They advised future studies evaluating longitudinal changes in anticoagulation treatment patterns and outcomes among patients reclassified by the new guidelines.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Kim S, Hess PL .
Effect of the 2014 atrial fibrillation guideline revisions on the proportion of patients recommended for oral anticoagulation.
JAMA Intern Med 2015 May;175(5):848-50. doi: 10.1001/jamainternmed.2015.13.
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Keywords: Heart Disease and Health, Blood Thinners, Guidelines, Medication, Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research
Ballesca MA, LaGuardia JC, Le PC
An electronic order set for acute myocardial infarction is associated with improved patient outcomes through better adherence to clinical practice guidelines.
The researchers investigated the association between the use of an evidence-based, electronic order set (OS) for acute myocardial infarction (AMI) and better adherence to clinical practice guidelines among 5,789 patients hospitalized with AMI. They found that use of the electronic OS is associated with increased adherence to evidence-based therapies and lower 30-day mortality.
AHRQ-funded; HS018480
Citation: Ballesca MA, LaGuardia JC, Le PC .
An electronic order set for acute myocardial infarction is associated with improved patient outcomes through better adherence to clinical practice guidelines.
J Hosp Med 2014 Mar;9(3):155-61. doi: 10.1002/jhm.2149..
Keywords: Health Information Technology (HIT), Heart Disease and Health, Outcomes, Guidelines, Critical Care