National Healthcare Quality and Disparities Report
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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 25 of 114 Research Studies DisplayedBobo WV, Ryu E, Petterson TM
Bi-directional association between depression and HF: an electronic health records-based cohort study.
This study examined whether heart failure (HF) patients were more likely to be diagnosed with depression, or patients with depression were more likely to be diagnosed with HF. This retrospective cohort study utilized electronic health records (EHRs) from a large healthcare system in 2006 for adults who received primary care services. The EHR identified 10,649 people with depression, and 5,911 people with HF between 2006 to 2018. In the depression cohort there were 2,024 newly diagnosed occurrences of HF, and 944 occurrences of newly diagnosed depression in the HF cohort over 4-6 years of follow-up. There was a significantly higher risk of developing HF in the depression cohort than vice versa.
AHRQ-funded; HS023077.
Citation: Bobo WV, Ryu E, Petterson TM .
Bi-directional association between depression and HF: an electronic health records-based cohort study.
J Comorb 2020 Jan-Dec;10:2235042x20984059. doi: 10.1177/2235042x20984059..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Depression, Electronic Health Records (EHRs), Health Information Technology (HIT), Chronic Conditions
Stillman AE, Gatsonis C, Lima JAC
Coronary computed tomography angiography compared with single photon emission computed tomography myocardial perfusion imaging as a guide to optimal medical therapy in patients presenting with stable angina: the RESCUE trial.
Coronary computed tomography angiography compared with single photon emission computed tomography myocardial perfusion imaging as a guide to optimal medical therapy in patients presenting with stable angina: the RESCUE trial.
AHRQ-funded; HS019403.
Citation: Stillman AE, Gatsonis C, Lima JAC .
Coronary computed tomography angiography compared with single photon emission computed tomography myocardial perfusion imaging as a guide to optimal medical therapy in patients presenting with stable angina: the RESCUE trial.
J Am Heart Assoc 2020 Dec 15;9(24):e017993. doi: 10.1161/jaha.120.017993..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Imaging, Comparative Effectiveness, Evidence-Based Practice
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
Miller AC, Ward MM, Ullrich F
Emergency department telemedicine consults are associated with faster time-to-electrocardiogram and time-to-fibrinolysis for myocardial infarction patients.
The objective of this study was to evaluate the impact of telemedicine on the timeliness of emergency acute myocardial infarction (AMI) care for patients presenting to rural emergency departments (EDs) with chest pain. Findings showed that, in telemedicine networks, telemedicine consultation during the ED visit was associated with improved timeliness of electrocardiogram evaluation and increased use of fibrinolytic reperfusion therapy for rural AMI patients.
AHRQ-funded; HS025753.
Citation: Miller AC, Ward MM, Ullrich F .
Emergency department telemedicine consults are associated with faster time-to-electrocardiogram and time-to-fibrinolysis for myocardial infarction patients.
Telemed J E Health 2020 Dec;26(12):1440-48. doi: 10.1089/tmj.2019.0273..
Keywords: Telehealth, Health Information Technology (HIT), Emergency Department, Rural Health, Heart Disease and Health, Cardiovascular Conditions
Patel SA, Krasnow M, Long K
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Researchers examined whether neighborhood environment modifies the disparity in 30-day heart failure (HF) readmissions and mortality between Black and White patients in the Southeastern United States. They created a geocoded retrospective cohort of patients hospitalized for acute HF from 2010-2018 within Emory Healthcare. They found that excess 30-day HF readmissions and mortality were present among Black patients in every neighborhood strata and increased with progressive neighborhood socioeconomic deprivation.
AHRQ-funded; HS026081.
Citation: Patel SA, Krasnow M, Long K .
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Circ Heart Fail 2020 Dec;13(12):e007947. doi: 10.1161/circheartfailure.120.007947..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions, Racial and Ethnic Minorities, Mortality, Social Determinants of Health, Low-Income, Disparities
Savitz ST, Bailey SC, Dusetzina SB
Treatment selection and medication adherence for stable angina: the role of area-based health literacy.
Clinical studies show equivalent health outcomes from interventional procedures and treatment with medication only for stable angina patients. However, patients may be subject to overuse or access barriers for interventional procedures and may exhibit suboptimal adherence to medications. The objective of the study was to evaluate whether community-level health literacy was associated with treatment selection and medication adherence patterns.
AHRQ-funded; HS000032.
Citation: Savitz ST, Bailey SC, Dusetzina SB .
Treatment selection and medication adherence for stable angina: the role of area-based health literacy.
J Eval Clin Pract 2020 Dec;26(6):1711-21. doi: 10.1111/jep.13341..
Keywords: Medication, Patient Adherence/Compliance, Health Literacy, Heart Disease and Health, Cardiovascular Conditions
Mentias A, Briasoulis A, Vaughan Sarrazin MS
Trends, perioperative adverse events, and survival of patients with left ventricular assist devices undergoing noncardiac surgery.
This longitudinal cohort study examined outcomes of noncardiac surgery (NCS) in patients with left ventricular assist devices (LVADs). This study examined patients enrolled in Medicare who had undergone durable LVAD implantation from January 2012 to November 2017 with follow-up through December 2017. Primary outcome after NCS was major adverse cardiovascular events (MACEs), defined as in-hospital or 30-day all-cause mortality, ischemic stroke, or intracerebral hemorrhage. Of the 8118 patients with LVAD, 1326 underwent NCS with 75.4% emergent or urgent, and 24.6% elective. Both elective and urgent or emergent NCS was associated with higher mortality early and late compared with patients with LVAD who did not undergo NCS.
AHRQ-funded; HS023104.
Citation: Mentias A, Briasoulis A, Vaughan Sarrazin MS .
Trends, perioperative adverse events, and survival of patients with left ventricular assist devices undergoing noncardiac surgery.
JAMA Netw Open 2020 Nov 2;3(11):e2025118. doi: 10.1001/jamanetworkopen.2020.25118..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Medical Devices, Chronic Conditions, Outcomes, Adverse Events
Ajayi TB, Remein CD, Stafford RS
Cross-center virtual education fellowship program for early-career researchers in atrial fibrillation.
This paper discusses the results of the establishment of the atrial fibrillation (AF) Strategically Focused Research Network Cross-Center Fellowship Program to enhance the competencies of early-stage AF basic, clinical, and population health researchers through experiential education and mentorship. The effectiveness of the fellowship model was evaluated via mixed methods formative and summative surveys for the first 2 years. Productivity metrics were as high for the 12 fellows as they hoped with 50 AF-related manuscripts, 7 publications, 28 presentations, and 3 grant awards applications. The fellows reported medium to high satisfaction with the overall fellowship, webinar content and facilitation, staff communication and support, and program organization.
AHRQ-funded; HS026198.
Citation: Ajayi TB, Remein CD, Stafford RS .
Cross-center virtual education fellowship program for early-career researchers in atrial fibrillation.
Circ Arrhythm Electrophysiol 2020 Nov;13(11):e008552. doi: 10.1161/circep.120.008552..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Education: Curriculum, Education: Academic
Dewan M, O'Halloran A, Kleinman M
eStablish and Formalize Expert Criteria for Avoidable Resuscitation Review (SAFECARR) electronic Delphi: development of a consensus framework for classifying and reviewing cardiac arrests within the PICU.
The authors sought to develop a consensus framework to guide the process of classifying and reviewing pediatric in-hospital cardiac arrest in the PICU. A multidisciplinary group of pediatric resuscitation experts generated a consensus-based framework to classify and review pediatric in-hospital cardiac arrest in the PICU. The authors recommended that future work focus on the application of this framework and further validation of these definitions and contributing factors for in-hospital cardiac arrest both within and outside the PICU.
AHRQ-funded; HS026975.
Citation: Dewan M, O'Halloran A, Kleinman M .
eStablish and Formalize Expert Criteria for Avoidable Resuscitation Review (SAFECARR) electronic Delphi: development of a consensus framework for classifying and reviewing cardiac arrests within the PICU.
Pediatr Crit Care Med 2020 Nov;21(11):992-99. doi: 10.1097/pcc.0000000000002488..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality
Bavishi A, Bruce M, Ning H
Predictive accuracy of heart failure-specific risk equations in an electronic health record-based cohort.
The objective of this study was to assess the predictive accuracy of the Pooled Cohort Equations to Prevent Heart Failure within a primary prevention cohort derived from the electronic health record. Findings showed that a novel sex- and race-specific risk score predicts incident heart failure (HF) in a real-world, electronic health record-based cohort. Recommendations included integration of HF risk into the electronic health record to allow for risk-based discussion, enhanced surveillance, and targeted preventive interventions in order to reduce the public health burden of HF.
AHRQ-funded; HS026385.
Citation: Bavishi A, Bruce M, Ning H .
Predictive accuracy of heart failure-specific risk equations in an electronic health record-based cohort.
Circ Heart Fail 2020 Nov;13(11):e007462. doi: 10.1161/circheartfailure.120.007462..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Prevention, Risk
Groeneveld PW, Yang L, Segal AG
The effects of market competition on cardiologists' adoption of transcatheter aortic valve replacement.
This study examined the effects of market competition and unique regulations on cardiologists’ adoption of transcatheter aortic valve replacement (TAVR). This new technology was introduced around 2012. This retrospective cohort study looked at physician group practices (n=5116) from May 2012 through December 2014. Medicare claim data was used to indicate first usage. The Herfindahl-Hirschman Index was used to show that every 1000 point increase was associated with a 26% relative increase in the rate of TAVR adoption. This was most true in concentrated markets, and adoption of TAVR was favored by physician groups with greater market power.
AHRQ-funded; HS023615.
Citation: Groeneveld PW, Yang L, Segal AG .
The effects of market competition on cardiologists' adoption of transcatheter aortic valve replacement.
Med Care 2020 Nov;58(11):996-1003. doi: 10.1097/mlr.0000000000001391..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Medicare
Zullo AR, Riester MR, Erqou S
Comparative effectiveness of angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors in older nursing home residents after myocardial infarction: a retrospective cohort study.
Evidence regarding differences in outcomes between angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) among older nursing home (NH) residents after acute myocardial infarction (AMI) is limited. The purpose of this study was to estimate the post-AMI effects of ARBs versus ACEIs on mortality, rehospitalization, and functional decline outcomes in this important population.
AHRQ-funded; HS022998.
Citation: Zullo AR, Riester MR, Erqou S .
Comparative effectiveness of angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors in older nursing home residents after myocardial infarction: a retrospective cohort study.
Drugs Aging 2020 Oct;37(10):755-66. doi: 10.1007/s40266-020-00791-w..
Keywords: Elderly, Nursing Homes, Heart Disease and Health, Medication, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
Byrd TF, Ahmad FS, Liebovitz DM
Defragmenting heart failure care: medical records integration.
This article discusses the need to improve interoperability of software systems so that so that providers and patients can access clinical information needed to help coordinate care of heart failure patients. New data standards currently being proposed in legislation would make it possible to guide clinical decision-making.
AHRQ-funded; HS026385.
Citation: Byrd TF, Ahmad FS, Liebovitz DM .
Defragmenting heart failure care: medical records integration.
Heart Fail Clin 2020 Oct;16(4):467-77. doi: 10.1016/j.hfc.2020.06.007..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions, Data
Shah RU, Mutharasan RK, Ahmad FS
Development of a portable tool to identify patients with atrial fibrillation using clinical notes from the electronic medical record.
The electronic medical record contains a wealth of information buried in free text. In this study, the investigators created a natural language processing algorithm to identify patients with atrial fibrillation (AF) using text alone. The authors concluded that this approach allowed better use of the clinical narrative and created an opportunity for precise, high-throughput cohort identification.
AHRQ-funded; HS026385.
Citation: Shah RU, Mutharasan RK, Ahmad FS .
Development of a portable tool to identify patients with atrial fibrillation using clinical notes from the electronic medical record.
Circ Cardiovasc Qual Outcomes 2020 Oct;13(10):e006516. doi: 10.1161/circoutcomes.120.006516..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality
Wehbe RM, Khan SS, Shah SJ
Predicting high-risk patients and high-risk outcomes in heart failure.
Identifying patients with heart failure at high risk for poor outcomes is important for patient care, resource allocation, and process improvement. Although numerous risk models exist to predict mortality, hospitalization, and patient-reported health status, they are infrequently used for several reasons, including modest performance, lack of evidence to support routine clinical use, and barriers to implementation. The authors discuss the potential of artificial to enhance the performance of risk prediction models.
AHRQ-funded; HS026385.
Citation: Wehbe RM, Khan SS, Shah SJ .
Predicting high-risk patients and high-risk outcomes in heart failure.
Heart Fail Clin 2020 Oct;16(4):387-407. doi: 10.1016/j.hfc.2020.05.002..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Risk, Hospitalization
Khera R, Kondamudi N, Zhong L
Temporal trends in heart failure incidence among Medicare
This retrospective, national cohort study looked at temporal trends in heart failure (HF) incidence among Medicare beneficiaries from 2011 to 2016. There had been a decline in claims during that time period. Five percent of all fee-for-service Medicare beneficiaries with no prior HF diagnosis were followed up from 2011-2016. Annual trends were examined in HF incidence among groups with and without primary HF risk factors (hypertension, diabetes, and obesity) and predisposing cardiovascular conditions (acute myocardial infarction (MI) and atrial fibrillation (AF). Of the approximately 1.8 million Medicare beneficiaries at risk for HF, 249,832 had a new diagnosis of HF. The prevalence of all 5 risk factors had increased during the 5-year study period. There was a relative decline in HF incidence among beneficiaries with primary HF risk factors, but incidence increased among individuals with acute MI and AF.
AHRQ-funded; HS022418.
Citation: Khera R, Kondamudi N, Zhong L .
Temporal trends in heart failure incidence among Medicare
JAMA Netw Open 2020 Oct;3(10):e2022190. doi: 10.1001/jamanetworkopen.2020.22190.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Medicare, Risk, Elderly, Mortality
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
O'Halloran JA, Sahrmann J, Butler AM
Brief report: integrase strand transfer inhibitors are associated with lower risk of incident cardiovascular disease in people living with HIV.
AHRQ-funded; HS019455.
Citation: O'Halloran JA, Sahrmann J, Butler AM .
Brief report: integrase strand transfer inhibitors are associated with lower risk of incident cardiovascular disease in people living with HIV.
J Acquir Immune Defic Syndr 2020 Aug 1;84(4):396-99. doi: 10.1097/qai.0000000000002357..
Keywords: Human Immunodeficiency Virus (HIV), Cardiovascular Conditions, Medication, Stroke, Heart Disease and Health, Risk
Jackson LR, Kim S, Blanco R
Discontinuation rates of warfarin versus direct acting oral anticoagulants in US clinical practice: results from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II).
The objective of this study was to evaluate discontinuation rates among patients on warfarin and direct oral anticoagulants (DOACs) in clinical practice. Over 10,000 AF patients were enrolled from the ORBIT-AF II Registry as subjects. Findings showed that, in a community based atrial fibrillation cohort, adjusted rates of discontinuation at 12 months were higher in DOAC-treated versus vitamin K antagonist-treated patients. Discontinuation of oral anticoagulation was associated with increased absolute risk of all-cause mortality and cardiovascular death.
AHRQ-funded; HS021092.
Citation: Jackson LR, Kim S, Blanco R .
Discontinuation rates of warfarin versus direct acting oral anticoagulants in US clinical practice: results from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II).
Am Heart J 2020 Aug;226:85-93. doi: 10.1016/j.ahj.2020.04.016..
Keywords: Blood Thinners, Medication, Registries, Stroke, Heart Disease and Health, Cardiovascular Conditions, Outcomes
Halladay JR, Weiner BJ, In Kim J
Practice level factors associated with enhanced engagement with practice facilitators; findings from the Heart Health Now study.
In this analysis, the authors explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month practice facilitation intervention focused on implementing cardiovascular prevention activities in practice. Using data from the EvidenceNow initiative's NC Cooperative, named Heart Health Now, they found that their analysis provided information for practice facilitation stakeholders to consider when determining which practices may be more amendable to embracing facilitation services.
AHRQ-funded; HS023912.
Citation: Halladay JR, Weiner BJ, In Kim J .
Practice level factors associated with enhanced engagement with practice facilitators; findings from the Heart Health Now study.
BMC Health Serv Res 2020 Jul 28;20(1):695. doi: 10.1186/s12913-020-05552-4.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Evidence-Based Practice, Teams
Moon J, Shen L, Likosky DS
Relationship of ventricular morphology and atrioventricular valve function to long-term outcomes following fontan procedures.
This study hypothesized that dysfunction of the single right ventricle (RV) and right atrioventricular valve regurgitation (AVVR) increases over time and adversely impacts late outcomes following a Fontan operation. Through a single-center retrospective study, findings showed that morphologic RV is negatively associated with the long-term survival following the Fontan, possibly due to a tendency toward progressive AVVR and deterioration of the single ventricle function. Additional volume overload caused by AVVR may be one of the main factors accelerating the dysfunction of the single RV, implying that early valve intervention may be warranted.
AHRQ-funded; HS026003.
Citation: Moon J, Shen L, Likosky DS .
Relationship of ventricular morphology and atrioventricular valve function to long-term outcomes following fontan procedures.
J Am Coll Cardiol 2020 Jul 28;76(4):419-31. doi: 10.1016/j.jacc.2020.05.059..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Outcomes
Khazanie P, Wynia MK, Dickert NW. P, Wynia MK, Dickert NW
Forced choices: ethical challenges in cardiology during the COVID-19 pandemic.
This article discusses the ethical dilemmas that cardiologists may face with cardiac patients due to the COVID-19 pandemic. The influx of patients threatens to exhaust resources in many hospitals and creates many challenges. These include determining the urgency of subacute and chronic cardiovascular diseases. Another challenge is critical care triage in cardiac patients. Protocols were developed during the 2009 H1N1 pandemic which are now adapted for the COVID-19 pandemic. The largest challenge has been interacting with patients and their families. A cardiac patient may not be able to go to an intensive care unit due to severe scarcity of beds and to minimize risks to them and the medical staff.
AHRQ-funded; R01 HS026081.
Citation: Khazanie P, Wynia MK, Dickert NW. P, Wynia MK, Dickert NW .
Forced choices: ethical challenges in cardiology during the COVID-19 pandemic.
Circulation 2020 Jul 21;142(3):194-96. doi: 10.1161/circulationaha.120.047681..
Keywords: COVID-19, Cardiovascular Conditions, Heart Disease and Health, Public Health, Healthcare Delivery
Cornet VP, Toscos T, Bolchini D
Untold stories in user-centered design of mobile health: practical challenges and strategies learned from the design and evaluation of an app for older adults with heart failure.
This study’s goal was to characterize the practical challenges encountered and propose strategies when implementing user-centered design (UCD) for mHealth. Challenges identified included the timing of stakeholder involvement, overcoming designers' assumptions, adapting methods to end users, and managing heterogeneity among stakeholders. To address these challenges, this article provided practical recommendations to UCD researchers and practitioners.
AHRQ-funded; HS025232.
Citation: Cornet VP, Toscos T, Bolchini D .
Untold stories in user-centered design of mobile health: practical challenges and strategies learned from the design and evaluation of an app for older adults with heart failure.
JMIR Mhealth Uhealth 2020 Jul 21;8(7):e17703. doi: 10.2196/17703..
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT)
Hadler RA, Curtis BR, Ikejiani DZ
"I'd have to basically be on my deathbed": heart failure patients' perceptions of and preferences for palliative care.
This cohort study examined individuals with New York Heart Association Class II-IV disease attitude towards palliative care (PC). Participants were recruited from inpatient and outpatient settings at an academic quaternary care hospital. They were given semistructured interviews discussing perceptions, knowledge, and preferences regarding PC, and also barriers to to PC delivery by facilitators. They interviewed 27 adults with heart failure (mean age 63, 85% white, 63% male). Participants frequently confused PC with hospice but once corrected they expressed variable preferences for primary versus specialist services. Preferences for primary versus specialist PC were based on different factors. Although there was more understanding of PC after the interviews, triggers for initiation remained focused on late-stage disease.
AHRQ-funded; HS022989.
Citation: Hadler RA, Curtis BR, Ikejiani DZ .
"I'd have to basically be on my deathbed": heart failure patients' perceptions of and preferences for palliative care.
J Palliat Med 2020 Jul;23(7):915-21. doi: 10.1089/jpm.2019.0451..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Palliative Care, Clinician-Patient Communication, Communication, Chronic Conditions
Haynes SC, Tancredi DJ, Tong K
Association of adherence to weight telemonitoring with health care use and death: a secondary analysis of a randomized clinical trial.
This study examined if heart failure patients who had lower adherence to weight telemonitoring had higher hospitalization and death rates. This study was a post hoc secondary analysis of the Better Effectiveness After Transition-Heart Failure randomized clinical trial which included patients from 6 academic medical centers in California. Criteria for eligibility was if they were hospitalized for decompensated heart failure. Exclusion criteria included if they were discharged to a skilled nursing facility, were expected to improve because of a medical procedure, or did not have the cognitive or physical ability to participate. The trial compared a telemonitoring intervention with usual care for patients with heart failure after hospital discharge from October 12, 2011 to September 30, 2013. The cohort of 538 eligible participants had a mean age of 70.9, was 53.8% male and 50.7% white. Adherence got better from week to week, and they found that every increase in adherence by 1 day was associated with a 19% decrease in the rate of death the following week and an 11% decrease in the rate of hospitalization. However, weight adherence is unlikely to be a result of the telemonitoring intervention.
AHRQ-funded; HS019311.
Citation: Haynes SC, Tancredi DJ, Tong K .
Association of adherence to weight telemonitoring with health care use and death: a secondary analysis of a randomized clinical trial.
JAMA Netw Open 2020 Jul;3(7):e2010174. doi: 10.1001/jamanetworkopen.2020.10174..
Keywords: Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance, Obesity: Weight Management, Obesity, Heart Disease and Health, Cardiovascular Conditions, Hospitalization