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
51 to 75 of 89 Research Studies DisplayedNgo-Metzger Q, Zuvekas SH, Bierman AS
AHRQ Author: Ngo-Metzger Q, Zuvekas SH, Bierman AS
Estimated impact of US Preventive Services Task Force Recommendations on use and cost of statins for cardiovascular disease prevention.
The purpose of the study was to assess the US population meeting criteria for statin use and factors associated with use, and calculate associated costs. The study concluded that new USPSTF recommendations may result in decreased out-of-pocket costs and expanded access to statins. Previous research has shown that eliminating copayments increased adherence and decreased rates of ASCVD events without increasing overall healthcare costs.
AHRQ-authored.
Citation: Ngo-Metzger Q, Zuvekas SH, Bierman AS .
Estimated impact of US Preventive Services Task Force Recommendations on use and cost of statins for cardiovascular disease prevention.
J Gen Intern Med 2018 Aug;33(8):1317-23. doi: 10.1007/s11606-018-4497-4..
Keywords: Cardiovascular Conditions, Healthcare Costs, Medication, Prevention, U.S. Preventive Services Task Force (USPSTF)
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)
Fudim M, Liu PR, Shrader P
Mineralocorticoid receptor antagonism in patients with atrial fibrillation: findings from the ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry.
Mineralocorticoid receptor antagonist (MRA) therapy may be beneficial to patients with atrial fibrillation (AF), but little is known about their use in patients with AF and subsequent outcomes. In order to better understand MRA use and subsequent outcomes, the investigators performed a retrospective cohort study of the contemporary ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry.
AHRQ-funded; HS021092.
Citation: Fudim M, Liu PR, Shrader P .
Mineralocorticoid receptor antagonism in patients with atrial fibrillation: findings from the ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry.
J Am Heart Assoc 2018 Apr 13;7(8). doi: 10.1161/jaha.117.007987..
Keywords: Cardiovascular Conditions, Evidence-Based Practice, Heart Disease and Health, Medication, Outcomes, Patient-Centered Outcomes Research, Prevention, Registries, Stroke
Wang SV, Huybrechts KF, Fischer MA
Generalized boosted modeling to identify subgroups where effect of dabigatran versus warfarin may differ: an observational cohort study of patients with atrial fibrillation.
The purpose of this study was to explore generalized boosted modeling (GBM) as a method for identifying subgroups with greater benefit or harm with dabigatran versus warfarin for treatment of atrial fibrillation. The investigators concluded that dabigatran's superiority to warfarin at prevention of thromboembolism may be greater in secondary than primary prevention. They indicated that in practice, secondary prevention patients are more often treated with warfarin.
AHRQ-funded; HS022193.
Citation: Wang SV, Huybrechts KF, Fischer MA .
Generalized boosted modeling to identify subgroups where effect of dabigatran versus warfarin may differ: an observational cohort study of patients with atrial fibrillation.
Pharmacoepidemiol Drug Saf 2018 Apr;27(4):383-90. doi: 10.1002/pds.4395..
Keywords: Blood Clots, Blood Thinners, Cardiovascular Conditions, Comparative Effectiveness, Evidence-Based Practice, Heart Disease and Health, Medication, Outcomes, Patient-Centered Outcomes Research, Prevention
Reeves SL, Tribble AC, Madden B
Antibiotic prophylaxis for children with sickle cell anemia.
This study calculated the proportion of children with sickle cell anemia (SCA) who received at least 300 days of antibiotic prophylaxis against invasive pneumococcal disease and identified predictors of receipt. Children with SCA between 3 months and 5 years old were identified by the presence of three or more Medicaid claims with a diagnosis of SCA within a calendar year in six states. Receipt of antibiotics was identified through claims for filled prescriptions. The authors conclude that antibiotic prophylaxis rates are low among children with SCA; more healthcare encounters may offer opportunities for increased intervention. Potential predictors were identified as age, sex, year, state, and health services usage.
AHRQ-funded; HS020516.
Citation: Reeves SL, Tribble AC, Madden B .
Antibiotic prophylaxis for children with sickle cell anemia.
Pediatrics 2018 Mar;141(3). doi: 10.1542/peds.2017-2182..
Keywords: Sickle Cell Disease, Children/Adolescents, Antibiotics, Prevention, Pneumonia, Medication
Goto T, Faridi MK, Camargo CA
The association of aspirin use with severity of acute exacerbation of chronic obstructive pulmonary disease: a retrospective cohort study.
The researchers hypothesized that, in patients hospitalized for acute exacerbation of COPD (AECOPD), long-term aspirin use is associated with lower risks of disease severity (in-hospital death, mechanical ventilation use, and hospital length-of-stay). They found that in patients with AECOPD, aspirin use was associated with lower rates of in-hospital mortality and invasive mechanical ventilation use, and shorter length-of-stay.
AHRQ-funded; HS023305.
Citation: Goto T, Faridi MK, Camargo CA .
The association of aspirin use with severity of acute exacerbation of chronic obstructive pulmonary disease: a retrospective cohort study.
NPJ Prim Care Respir Med 2018 Feb 21;28(1):7. doi: 10.1038/s41533-018-0074-x.
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Keywords: Respiratory Conditions, Medication, Patient-Centered Outcomes Research, Prevention
Fink HA, Jutkowitz E, McCarten JR
Pharmacologic interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
This review summarized current evidence on the efficacy and harms of pharmacologic interventions to prevent or delay cognitive decline, mild cognitive impairment (MCI), or dementia in adults with normal cognition or MCI. It concluded that evidence does not support use of the studied pharmacologic treatments for cognitive protection in persons with normal cognition or MCI.
AHRQ-funded; 290201500008I.
Citation: Fink HA, Jutkowitz E, McCarten JR .
Pharmacologic interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
Ann Intern Med 2018 Jan 2;168(1):39-51. doi: 10.7326/m17-1529.
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Keywords: Comparative Effectiveness, Dementia, Medication, Patient-Centered Outcomes Research, Prevention
Lau BD, Streiff MB, Kraus PS
Missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals: cause for alarm.
This study examined the rate of missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals in the Washington, DC and greater Baltimore metropolitan areas. This retrospective study included four hospitals within the Johns Hopkins Health System. Non-administration of VTE prophylaxis was found 10.9% to 15.0% of the time among the three community hospitals. About 43.6% of patients missed at least one dose in all four hospitals. The investigators weren’t able to categorize patients by specialty, however it has been reported that more doses are missed with medically ill patients than other hospitalized patients.
AHRQ-funded; HS024547.
Citation: Lau BD, Streiff MB, Kraus PS .
Missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals: cause for alarm.
J Gen Intern Med 2018 Jan;33(1):19-20. doi: 10.1007/s11606-017-4203-y..
Keywords: Blood Clots, Prevention, Blood Thinners, Patient Adherence/Compliance, Medication, Hospitals
Ye S, Leppin AL, Chan AY
An informatics approach to implement support for shared decision making for primary prevention statin therapy.
The study authors designed an informatics decision-support tool to facilitate use of the Mayo Clinic Statin Choice decision aid at the point-of-care and evaluated its impact. The investigators found that implementation of a point-of-care decision-support tool increased the usage of decision aids for primary prevention statin therapy. This effect does not appear to be mediated by any concomitant changes in physician attitude toward shared decision making.
AHRQ-funded; HS025198.
Citation: Ye S, Leppin AL, Chan AY .
An informatics approach to implement support for shared decision making for primary prevention statin therapy.
MDM Policy Pract 2018 Jan-Jun;3(1):2381468318777752. doi: 10.1177/2381468318777752..
Keywords: Shared Decision Making, Health Information Technology (HIT), Medication, Prevention, Tools & Toolkits
Ngo-Metzger Q, Gottfredson R
AHRQ Author: Ngo-Metzger Q
Statin use for the primary prevention of cardiovascular disease in adults.
This case study concerns a 66-year-old generally healthy white man, who presents for his annual physical. He has no history of cardiovascular disease (CVD); he has had consistent systolic blood pressure measurements of 140 mm Hg. You calculate his 10-year risk of a CVD event to be 16.7 percent. The case study poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Ngo-Metzger Q, Gottfredson R .
Statin use for the primary prevention of cardiovascular disease in adults.
Am Fam Physician 2017 Dec 15;96(12):805-06.
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Keywords: Cardiovascular Conditions, Case Study, Medication, Prevention, U.S. Preventive Services Task Force (USPSTF)
Zullo AR, Sharmin S, Lee Y
Secondary prevention medication use after myocardial infarction in U.S. nursing home residents.
This study evaluated new use of secondary prevention medications after acute myocardial infarction (AMI) in NH residents who were previously nonusers and to evaluate what factors were associated with use. More than one-third of older NH residents in the United States do not have any secondary prevention medications initiated after AMI, with fewer medications initiated in older residents; women; and those with, DNR orders, poor physical function, and cognitive impairment.
AHRQ-funded; HS022998.
Citation: Zullo AR, Sharmin S, Lee Y .
Secondary prevention medication use after myocardial infarction in U.S. nursing home residents.
J Am Geriatr Soc 2017 Nov;65(11):2397-404. doi: 10.1111/jgs.15144.
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Keywords: Elderly, Medication, Heart Disease and Health, Nursing Homes, Prevention
Balbale SN, Trivedi I, O'Dwyer LC
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
In this study, the investigators conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders. They concluded that prescription drug monitoring and self-management interventions may be promising strategies to identify and reduce opioid misuse in GI care. They suggest that rigorous, empirical research is needed to evaluate the longer-term impact of these strategies.
AHRQ-funded; HS000084.
Citation: Balbale SN, Trivedi I, O'Dwyer LC .
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
Dig Dis Sci 2017 Oct;62(10):2668-85. doi: 10.1007/s10620-017-4705-9..
Keywords: Behavioral Health, Chronic Conditions, Digestive Disease and Health, Medication, Medication: Safety, Opioids, Patient Self-Management, Prevention, Substance Abuse
Olsen MA, Nickel KB, Fraser VJ
Prevalence and predictors of postdischarge antibiotic use following mastectomy.
This study determined utilization, predictors, and outcomes of postdischarge prophylactic antibiotics after mastectomy with or without immediate breast reconstruction. The study conclude that prophylactic postdischarge antibiotics are commonly prescribed after mastectomy; immediate reconstruction is the strongest predictor. The authors recommended stewardship efforts in this population to limit continuation of prophylactic antibiotics after discharge are needed to limit antimicrobial resistance.
AHRQ-funded; HS019455.
Citation: Olsen MA, Nickel KB, Fraser VJ .
Prevalence and predictors of postdischarge antibiotic use following mastectomy.
Infect Control Hosp Epidemiol 2017 Sep;38(9):1048-54. doi: 10.1017/ice.2017.128.
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Keywords: Antibiotics, Healthcare-Associated Infections (HAIs), Medication, Patient Safety, Surgery, Injuries and Wounds, Prevention, Adverse Events, Risk
Lau BD, Shaffer DL, Hobson DB
Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: a randomized clinical trial.
Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: a randomized clinical trial.
AHRQ-funded; HS024547.
Citation: Lau BD, Shaffer DL, Hobson DB .
Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: a randomized clinical trial.
PLoS One 2017 Aug 16;12(8):e0181664. doi: 10.1371/journal.pone.0181664.
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Keywords: Blood Clots, Education: Continuing Medical Education, Medication, Nursing, Prevention, Provider: Nurse, Web-Based, Practice Patterns
Obremskey WT, Schmidt AH, O'Toole RV
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
The POvIV study is a prospective, multicenter, randomized trial to compare oral (PO) with intravenous (IV) antibiotic therapy in patients with postoperative wound infections after extremity fractures. This study will be the largest prospective randomized trial to evaluate the safety and effectiveness of PO antibiotic use for treatment of postoperative wound infections. Results will inform clinician decisions on antibiotic delivery in patients with postoperative wound infections.
AHRQ-funded; HS000029.
Citation: Obremskey WT, Schmidt AH, O'Toole RV .
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
J Orthop Trauma 2017 Apr;31 Suppl 1:S32-s38. doi: 10.1097/bot.0000000000000802.
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Keywords: Antibiotics, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Medication, Patient Safety, Adverse Events, Prevention, Patient-Centered Outcomes Research, Outcomes
Encinosa W, Davidoff AJ
AHRQ Author: Encinosa W
Changes in antiemetic overuse in response to Choosing Wisely recommendations.
Antiemetics are used to prevent chemotherapy-induced nausea and vomiting in patients with cancer. Newer antiemetic agents (serotonin and neurokinin-1 receptor antagonists) have increased efficacy but are expensive. This study estimating the baseline prevalence, trends, determinants, and costs of antiemetic overuse found that antiemetic overuse is prevalent and results in unnecessary spending associated with systemic chemotherapy treatment.
AHRQ-authored.
Citation: Encinosa W, Davidoff AJ .
Changes in antiemetic overuse in response to Choosing Wisely recommendations.
JAMA Oncol 2017 Mar;3(3):320-26. doi: 10.1001/jamaoncol.2016.2530.
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Keywords: Guidelines, Medication, Prevention, Shared Decision Making
Naidech AM, Toledo P, Prabhakaran S
Disparities in the use of seizure medications after intracerebral hemorrhage.
The researchers investigated potential disparities in the use of prophylactic seizure medications in patients with intracerebral hemorrhage. They concluded that although multicenter electronic health record data showed apparent racial/ethnic disparities in the use of prophylactic seizure medications, a more complete single-center cohort found the apparent disparity to be confounded by the clinical factors of hypertension and hematoma location.
AHRQ-funded; HS023437; HS000078.
Citation: Naidech AM, Toledo P, Prabhakaran S .
Disparities in the use of seizure medications after intracerebral hemorrhage.
Stroke 2017 Mar;48(3):802-04. doi: 10.1161/strokeaha.116.015779.
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Keywords: Disparities, Medication, Prevention, Adverse Drug Events (ADE), Risk
Schmajuk G, Tonner C, Trupin L
Using health-system-wide data to understand hepatitis B virus prophylaxis and reactivation outcomes in patients receiving rituximab.
Hepatitis B virus (HBV) reactivation in the setting of rituximab use is a potentially fatal but preventable safety event. The rate of HBV screening and proportion of patients at risk who receive antiviral prophylaxis in patients initiating rituximab is unknown. This study found wide variations in hepatitis B screening practices among patients receiving rituximab, resulting in unnecessary risks to patients.
AHRQ-funded; HS023558; HS024412.
Citation: Schmajuk G, Tonner C, Trupin L .
Using health-system-wide data to understand hepatitis B virus prophylaxis and reactivation outcomes in patients receiving rituximab.
Medicine 2017 Mar;96(13):e6528. doi: 10.1097/md.0000000000006528.
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Keywords: Hepatitis, Electronic Health Records (EHRs), Medication, Prevention, Patient Safety
Pannucci CJ, Rondina MT
Should we be following anti-factor Xa levels in patients receiving prophylactic enoxaparin perioperatively?
The authors argue that existing data demonstrate that an individualized regimen of enoxaparin prophylaxis based on patient-level factors might provide an increased margin of effectiveness and safety for individual patients given enoxaparin prophylactically in the perioperative period.
AHRQ-funded; HS024326.
Citation: Pannucci CJ, Rondina MT .
Should we be following anti-factor Xa levels in patients receiving prophylactic enoxaparin perioperatively?
Surgery 2017 Feb;161(2):329-31. doi: 10.1016/j.surg.2016.07.038.
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Keywords: Adverse Drug Events (ADE), Medication, Medication: Safety, Patient Safety, Prevention
Gans I, Jain A, Sirisreetreerux N
Current practice of antibiotic prophylaxis for surgical fixation of closed long bone fractures: a survey of 297 members of the Orthopaedic Trauma Association.
This study found heterogeneity in the use of single- versus multiple-dose antibiotic prophylaxis for surgical repair of closed long bone fractures. Many surgeons were unsure of current evidence-based recommendations regarding perioperative antibiotic use. Most respondents indicated they would be receptive to high-level evidence regarding the single- versus multiple-dose perioperative prophylactic antibiotics for the treatment of closed long bone fractures.
AHRQ-funded; HS024547.
Citation: Gans I, Jain A, Sirisreetreerux N .
Current practice of antibiotic prophylaxis for surgical fixation of closed long bone fractures: a survey of 297 members of the Orthopaedic Trauma Association.
Patient Saf Surg. 2017 Jan 16;11:2. doi: 10.1186/s13037-016-0118-5.
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Keywords: Injuries and Wounds, Healthcare-Associated Infections (HAIs), Medication, Prevention, Surgery
Shekelle PG, Newberry SJ, FitzGerald JD
Management of gout: a systematic review in support of an American College of Physicians clinical practice guideline.
The authors reviewed evidence about treatment of acute gout attacks, management of hyperuricemia to prevent attacks, and discontinuation of medications for chronic gout in adults. They concluded that colchicine, NSAIDs, and corticosteroids relieve pain in adults with acute gout. Urate-lowering therapy decreases serum urate levels and reduces risk for acute gout attacks.
AHRQ-funded; 290201200006I.
Citation: Shekelle PG, Newberry SJ, FitzGerald JD .
Management of gout: a systematic review in support of an American College of Physicians clinical practice guideline.
Ann Intern Med 2017 Jan 3;166(1):37-51. doi: 10.7326/m16-0461.
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Keywords: Evidence-Based Practice, Guidelines, Prevention, Medication, Comparative Effectiveness
Chou R, Dana T, Blazina I
Statins for prevention of cardiovascular disease in adults: Evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this report systematically reviewed benefits and harms of statins for prevention of cardiovascular disease (CVD), in order to inform the US Preventive Services Task Force. It concluded that in adults at increased CVD risk but without prior CVD events, statin therapy was associated with reduced risk of all-cause and cardiovascular mortality and CVD events, with greater absolute benefits in patients at greater baseline risk.
AHRQ-funded; 2902012000015I.
Citation: Chou R, Dana T, Blazina I .
Statins for prevention of cardiovascular disease in adults: Evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Nov 15;316(19):2008-24. doi: 10.1001/jama.2015.15629.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Prevention, Cardiovascular Conditions, Medication, Evidence-Based Practice
McNellis RJ, Beswick-Escanlar V
AHRQ Author: McNellis RJ
Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer.
This case study involves a a 55-year-old man who presents to your office for a routine refill of his antihypertension medication, his 65-year-old brother who also visits you to ask about taking low-dose aspirin, and his 55-year-old wife, also your patient, who recently experienced abdominal pain,. It poses three multiple choice questions focused on the use of low-dose aspirin, together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: McNellis RJ, Beswick-Escanlar V .
Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer.
Am Fam Physician 2016 Oct 15;94(8):661-62.
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Keywords: Cancer: Colorectal Cancer, Cardiovascular Conditions, Medication, Prevention, U.S. Preventive Services Task Force (USPSTF), Case Study
Gernant SA, Snyder ME, Jaynes H
The effectiveness of pharmacist-provided telephonic medication therapy management on emergency department utilization in home health patients.
This article's objective is to evaluate the effectiveness of a telephonic medication therapy management (MTM) service on reducing emergency department utilization within a Medicare-insured home health population. The authors found that this pharmacist-delivered telephonic medication therapy management program did not decrease emergency department utilization overall but may further reduce the such risk among patients who are at lower risk of utilization.
AHRQ-funded; HS022119.
Citation: Gernant SA, Snyder ME, Jaynes H .
The effectiveness of pharmacist-provided telephonic medication therapy management on emergency department utilization in home health patients.
J Pharm Technol 2016 Oct 1;32(5):179-84. doi: 10.1177/8755122516660376.
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Keywords: Care Management, Emergency Department, Medication, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Provider: Pharmacist, Provider
Karmali KN, Lee JY, Brown T
Predictors of cholesterol treatment discussions and statin prescribing for primary cardiovascular disease prevention in community health centers.
The authors aimed to identify factors associated with a cholesterol treatment discussion and statin prescribing in a high-risk population. They found that single risk factor management strongly influences cholesterol treatment discussions and statin prescribing patterns, and they recommended interventions that promote risk-based statin use.
AHRQ-funded; HS021141.
Citation: Karmali KN, Lee JY, Brown T .
Predictors of cholesterol treatment discussions and statin prescribing for primary cardiovascular disease prevention in community health centers.
Prev Med 2016 Jul;88:176-81. doi: 10.1016/j.ypmed.2016.04.011.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Community-Based Practice, Medication, Prevention