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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 588 Research Studies Displayed
Kowitt SD, Goldstein AO, Cykert S
A heart healthy intervention improved tobacco screening rates and cessation support in primary care practices.
This study investigated the outcomes of an evidence-based cardiovascular disease risk reduction tool called Heart Health Now to improve rates for tobacco cessation screening and counseling in small primary care practices in North Carolina. This tool was developed as part of AHRQ’s EvidenceNow initiative. This stepped wedge, stratified, cluster randomized trial looked at 28 practices that were staffed by 10 or fewer clinicians and had an electronic health record. Heart Health Now consisted of education tools, onsite practice facilitation for a year, and a practice-specific cardiovascular population management dashboard that included monthly, measure-specific run charts to help guide quality improvement. The practices included in their analyses consisted of 78,120 patients, and 17,687 smokers. From pre- to post-intervention, screening rates significantly increased from 82.7 to 96.2%. Cessation support rates also significantly increased from 44.3% to 50.1%. Some of the practices associated with improvement included being in an academic health center or faculty, having more clinicians, and having a lower percentage of White patients.
Citation: Kowitt SD, Goldstein AO, Cykert S . A heart healthy intervention improved tobacco screening rates and cessation support in primary care practices. J Prev 2022 Jun;43(3):375-86. doi: 10.1007/s10935-022-00672-5..
Keywords: Tobacco Use, Tobacco Use: Smoking Cessation, Screening, Primary Care, Evidence-Based Practice, Heart Disease and Health, Cardiovascular Conditions
Marino M, Solberg L, Springer R
Cardiovascular disease preventive services among smaller primary care practices.
This cross-sectional study utilized linear regression modeling to examine the association of aspirin use, blood pressure control, and smoking-cessation support performance with practice characteristics that included structural attributes, practice capacity and contextual characteristics, health information technology, and patient panel demographics. Findings showed that, on average, practice performance on aspirin use, blood pressure control, and smoking-cessation support quality measures was 64% for aspirin, 63% for blood pressure, and 62% for smoking-cessation support. Practice characteristics associated with aspirin use, blood pressure control, and smoking-cessation support performance included ownership, rurality, and disruptions.
Citation: Marino M, Solberg L, Springer R . Cardiovascular disease preventive services among smaller primary care practices. Am J Prev Med 2022 May;62(5):e285-e95. doi: 10.1016/j.amepre.2021.10.011..
Keywords: Cardiovascular Conditions, Primary Care, Prevention
Guirguis-Blake JM, Evans CV, Perdue LA
Aspirin use to prevent cardiovascular disease and colorectal cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
This evidence summary reviewed the benefits and harms of aspirin in primary cardiovascular disease (CVD) and colorectal cancer (CRC) prevention to accompany the final recommendation and evidence review of the US Preventive Services Task Force. A literature review was conducted of English-language randomized clinical trials (RCTs) of low-dose aspirin compared with placebo or no intervention in primary prevention populations. Aspirin was found not to be significantly associated with reductions in CVD mortality or all-cause mortality. There was limited trial evidence on benefits for CRC, with the findings highly variable by length of follow-up and statistically significant only when considering long-term observational follow-up beyond randomized trial periods. Low-dose aspirin was associated with significant increases in total major bleeding and in site-specific bleeding.
Citation: Guirguis-Blake JM, Evans CV, Perdue LA . Aspirin use to prevent cardiovascular disease and colorectal cancer: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 2022 Apr 26;327(16):1585-97. doi: 10.1001/jama.2022.3337..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Cancer: Colorectal Cancer, Cancer, Prevention, Evidence-Based Practice
Dehmer SP, O'Keefe LR, Evans CV
Aspirin use to prevent cardiovascular disease and colorectal cancer: updated modeling study for the US Preventive Services Task Force.
The purpose of the study was to develop, model, and report estimates of the harms from and benefits of the use of low-dose aspirin for the prevention of cardiovascular disease (CVD) and colorectal cancer (CRC.) The researchers developed and used a simulation model to provide estimates for hypothetical United States cohorts of men and women between the ages of forty and seventy-nine years without a previous history of elevated bleeding risks or CVD, and up to a 20% 10-year risk for a CVD event. The model focused on the routine, lifetime use of low-dose aspirin with 5-year intervals of no use between 65 and 85 years of age. The study’s primary outcome was lifetime net benefit which was measured in life-years and quality-adjusted life-years (QALYs.) Harms included an increase in nonfatal intracranial hemorrhage and gastrointestinal bleeding, and benefits included a reduction in nonfatal ischemic stroke and myocardial infarction. The study found that the estimated lifetime net quality-adjusted life-years was positive for men and women with 5% or more 10-year CVD risk when they started use between the ages of 40-59 years, and for men and women with 10% or greater 10-year CVD risk when starting between the ages of 60 and 69 years. The estimated lifetime net life-years were mostly negative for those starting low-dose aspirin use between 60 and 79 years of age. Five-year intervals of stopping use between 65 and 85 years of age did not provide a significant advantage to lifetime use. The researchers concluded that the routine, lifetime use of low-dose aspirin may benefit several population groups, with the largest estimated benefit in those with greater 10-year CVD risk who begin routine, low-dose aspirin dosage at younger ages.
Citation: Dehmer SP, O'Keefe LR, Evans CV . Aspirin use to prevent cardiovascular disease and colorectal cancer: updated modeling study for the US Preventive Services Task Force. JAMA 2022 Apr 26;327(16):1598-607. doi: 10.1001/jama.2022.3385..
Keywords: U.S. Preventive Services Task Force (USPSTF), Prevention, Cardiovascular Conditions, Cancer: Colorectal Cancer, Cancer, Prevention, Evidence-Based Practice
Mihandoust S, Joseph A, Madathil KC
Comparing sources of disruptions to telemedicine-enabled stroke care in an ambulance.
This study investigated the nature and source of disruptions in an ambulance during the telemedicine-based caregiving process for stroke patients to enhance the ambulance design for supporting telemedicine-based care. Thirteen simulated telemedicine-based stroke consults were video recorded and then coded and analyzed using an existing systems-based flow disruption (FD) taxonomy. Factors that impacted disruptions included seat size, arrangement of assessment equipment, location of telemedicine equipment, and design of the telemedicine camera. The left ambulance seat zone and head of the patient bed had more environmental hazard-related disruptions, while the right zone was more prone to interruptions and communication-related disruptions.
Citation: Mihandoust S, Joseph A, Madathil KC . Comparing sources of disruptions to telemedicine-enabled stroke care in an ambulance. HERD 2022 Apr;15(2):96-115. doi: 10.1177/19375867211054759..
Keywords: Telehealth, Health Information Technology (HIT), Stroke, Cardiovascular Conditions, Emergency Medical Services (EMS)
Commodore-Mensah Y, Loustalot F, Himmelfarb CD CD
AHRQ Author: McNellis R
Proceedings from a National Heart, Lung, and Blood Institute and the Centers for Disease Control and Prevention workshop to control hypertension.
In order to address the rapid decline in hypertension control, the National Heart, Lung, and Blood Institute and the Division for Heart Disease and Stroke Prevention of the Centers for Disease Control and Prevention convened a virtual workshop with multidisciplinary national experts. The presentations and discussions included potential reasons for the decline and challenges in hypertension control, possible "big ideas," and multisector approaches that could reverse the current trend while addressing knowledge gaps and research priorities.
Citation: Commodore-Mensah Y, Loustalot F, Himmelfarb CD CD . Proceedings from a National Heart, Lung, and Blood Institute and the Centers for Disease Control and Prevention workshop to control hypertension. Am J Hypertens 2022 Mar 8;35(3):232-43. doi: 10.1093/ajh/hpab182..
Keywords: Hypertension, Blood Pressure, Prevention, Cardiovascular Conditions
Meng T, Trickey AM, Harris AHS
Lessons learned from the historical trends on thrombolysis use for acute ischemic stroke among Medicare beneficiaries in the United States.
The authors’ objectives were to assess and validate the change in intravenous thrombolysis (IVT) utilization in a national sample of Medicare beneficiaries and to examine the effect of patient, stroke center designation, and geography on IVT utilization. They found that, between 2007 and 2014, the frequency of IVT for patients with acute ischemic stroke increased substantially, though differences persisted in the form of less frequent treatment associated with certain characteristics.
Citation: Meng T, Trickey AM, Harris AHS . Lessons learned from the historical trends on thrombolysis use for acute ischemic stroke among Medicare beneficiaries in the United States. Front Neurol 2022 Mar 4;13:827965. doi: 10.3389/fneur.2022.827965..
Keywords: Stroke, Cardiovascular Conditions, Blood Thinners
Fitzgerald DC, Simpson AN, Baker RA DC, Simpson AN, Baker RA
Determinants of hospital variability in perioperative red blood cell transfusions during coronary artery bypass graft surgery.
This observational cohort study’s objective was to identify to what extent distinguishing patient and procedural characteristics can explain center-level transfusion variation during coronary artery bypass grafting (CABG) surgery. The study used patients from the Perfusion Measures and Outcomes Registry from 43 adult cardiac surgical programs from July 2011 through June 2017. Of the 22,272 adult patients undergoing isolate CABG surgery using cardiopulmonary bypass, 7241 (32.5%) received at least 1 U allogeneic red blood cells. Patients who received transfusions were older (68 vs 64 years), were women (41.5% vs 15.9%), and had a lower body surface area, respectively. The majority of center-level transfusion variations could not be explained through models containing both patient and intraoperative factors.
Citation: Fitzgerald DC, Simpson AN, Baker RA DC, Simpson AN, Baker RA . Determinants of hospital variability in perioperative red blood cell transfusions during coronary artery bypass graft surgery. J Thorac Cardiovasc Surg 2022 Mar;163(3):1015-24.e1. doi: 10.1016/j.jtcvs.2020.04.141..
Keywords: Surgery, Heart Disease and Health, Cardiovascular Conditions, Hospitals, Practice Patterns, Disparities
Yan Z, Nielsen V, Song G
Integration of regional hospitalizations, registry and vital statistics data for development of a single statewide ischemic stroke database.
The scope of population-based studies is often limited because databases rarely include detailed clinical variables and vital statistics such as death rates. The study team demonstrated a comprehensive process for integrating three clinical variable, vital statistics, and hospitalization databases into one single, statewide, ischemic stroke database. Using databases spanning 2007-2017, the authors identified and validated linkages between stroke admissions in a hospitalization database (47,713 admissions) and admissions in the stroke registry (43,487 admissions), resulting in 38,493 linked cases (80.7% of total cases) of which 95% were validated. Of the 38,493 linked cases, the authors linked 10,660 to deaths from the vital statistics database, resulting in a comprehensive assessment of cumulative mortality from ischemic strokes over a 7-year period among all registry-linked ischemic stroke hospitalization records. The authors concluded that comprehensive, accurate integration of the clinical registry, statewide hospitalizations, and vital statistics databases is achievable, and may have value for outcomes research on a larger scale.
Citation: Yan Z, Nielsen V, Song G . Integration of regional hospitalizations, registry and vital statistics data for development of a single statewide ischemic stroke database. J Stroke Cerebrovasc Dis 2022 Mar;31(3):106236. doi: 10.1016/j.jstrokecerebrovasdis.2021.106236..
Keywords: Stroke, Cardiovascular Conditions, Registries
Daley CN, Cornet VP, Toscos TR
Naturalistic decision making in everyday self-care among older adults with heart failure.
The purpose of this study was to explore the role of everyday decision-making on disease outcome in a group of older adults living with heart failure. The researchers describe such decisions as events of naturalistic decision-making which are influenced by factors such as the involvement of others, older adults’ social and physical environments, high stakes of the decision, and shifting goals. The researchers recruited 24 older adults with heart failure and 14 of their support persons from an ambulatory cardiology center, and conducted a qualitative field study. The study utilized a naturalistic decision-making model and critical incident technique to analyze health-related everyday decision making and determine how individuals make everyday health-related decisions. The study found that for various decisions, the decision-making of White, male, older adults aligned with the three phases of a preliminary model of naturalistic decision making: monitoring, interpreting, and acting. The researchers also determined that: health decisions are made in a context of personal variables such as emotions, priorities, and values; other people can play important roles; and the performance of the phases can be affected by barriers and strategies. The study concluded that the findings contribute to an expanded model of naturalistic decision-making with implications for not only future research, but for the design of interventions.
Citation: Daley CN, Cornet VP, Toscos TR . Naturalistic decision making in everyday self-care among older adults with heart failure. J Cardiovasc Nurs 2022 Mar-Apr;37(2):167-76. doi: 10.1097/jcn.0000000000000778..
Keywords: Elderly, Patient Self-Management, Decision Making, Heart Disease and Health, Cardiovascular Conditions
Mota L, Marcaccio CL, Dansey KD
Overview of screening eligibility in patients undergoing ruptured AAA repair from 2003 to 2019 in the Vascular Quality Initiative.
The authors examined patients in the Vascular Quality Initiative database who underwent repair of ruptured abdominal aortic aneurysm (AAA) to characterize those who are ineligible for screening under current guidelines and to evaluate the potential impact of these restrictions on their disease. They found that most patients who underwent ruptured AAA repair were ineligible for initial AAA screening or aged out of the screening window. Furthermore, ruptured AAA rates and screening ineligibility have not improved as much as expected since the passage of the Screening Abdominal Aortic Aneurysms Very Efficiently (SAAAVE) Act.
Citation: Mota L, Marcaccio CL, Dansey KD . Overview of screening eligibility in patients undergoing ruptured AAA repair from 2003 to 2019 in the Vascular Quality Initiative. J Vasc Surg 2022 Mar;75(3):884-92.e1. doi: 10.1016/j.jvs.2021.09.049..
Keywords: Cardiovascular Conditions, Screening, Prevention
de Loizaga SR, Schneider K, Beck AF
Socioeconomic impact on outcomes during the first year of life of patients with single ventricle heart disease: an analysis of the National Pediatric Cardiology Quality Improvement Collaborative Registry.
In a retrospective cohort analysis of infants enrolled in the National Pediatric Cardiology Improvement Collaborative, researchers investigated the impact of community-level deprivation on morbidity and mortality for infants with single ventricle heart disease in the first year of life. They found that community deprivation was associated with mortality and length of stay for patients with single ventricle congenital heart disease. While patients near the mean deprivation index had a higher hazard of one year mortality compared to those at the extremes of the deprivation index, length of stay and deprivation index were linearly associated, demonstrating the complex nature of socioeconomic factors.
Citation: de Loizaga SR, Schneider K, Beck AF . Socioeconomic impact on outcomes during the first year of life of patients with single ventricle heart disease: an analysis of the National Pediatric Cardiology Quality Improvement Collaborative Registry. Pediatr Cardiol 2022 Mar;43(3):605-15. doi: 10.1007/s00246-021-02763-2..
Keywords: Children/Adolescents, Social Determinants of Health, Quality Improvement, Quality of Care, Cardiovascular Conditions, Registries, Outcomes
Glober N, Supples M, Persaud S
A novel emergency medical services protocol to improve treatment time for large vessel occlusion strokes.
This paper describes the outcomes of a pilot study that used novel emergency medical services (EMS) protocol to expedite transfer of patients with large vessel occlusions (LVOs) to a comprehensive stroke center (CSC). The pilot study took place from Oct. 1, 2020 to Feb. 22, 2021 with Indianapolis EMS providers. In patients with possible LVO, the providers remained at the bedside until the clinical assessment and CT angiography were complete. This 5-month mixed methods study measured case-control assessment of the protocol, number of transfers, safety during transport, and time saved in transfer compared to emergency transfers via conventional interfacility transfer agencies. The protocol was used 42 times during the study period, with four patients found to have LVOs and transferred to a CSC. Median time from decision-to-transfer to arrival at the CSC was 27.5 minutes compared to 314.5 minutes for acute non-stroke transfers during the same period.
Citation: Glober N, Supples M, Persaud S . A novel emergency medical services protocol to improve treatment time for large vessel occlusion strokes. PLoS One 2022 Feb;17(2):e0264539. doi: 10.1371/journal.pone.0264539..
Keywords: Emergency Medical Services (EMS), Stroke, Cardiovascular Conditions, Critical Care
KS Cash, RE Adeoye, O
AHRQ Author: Zachrison
Estimated population access to acute stroke and telestroke centers in the US, 2019.
In order to provide an update on population-level access to stroke care, the investigators estimated the proportion of the US population with access to an ED with acute stroke capabilities and assessed the specific contribution of telestroke services to US population access. They observed a substantial increase in population access to acute stroke care in this cross-sectional study relative to previous reports using alternative methods, likely due to the extensive and ongoing work to improve stroke systems of care, including greater stroke center accreditation and expansion of telestroke capacity.
Citation: KS Cash, RE Adeoye, O . Estimated population access to acute stroke and telestroke centers in the US, 2019. JAMA Netw Open 2022 Feb;5(2):e2145824. doi: 10.1001/jamanetworkopen.2021.45824..
Keywords: Telehealth, Health Information Technology (HIT), Stroke, Cardiovascular Conditions, Critical Care, Access to Care
Mallela DP, Canner JK, Zarkowsky DS
Association between race and perioperative outcomes after carotid endarterectomy for asymptomatic carotid artery stenosis in NSQIP.
This study investigated the association of race on carotid endarterectomy (CEA) outcomes. Perioperative outcomes (at 30 days) were compared for Black vs. White patients adjusting for age/sex, comorbidities and disease characteristics. Out of 16,764 patients from the ACS-NSQIP targeted vascular database (2011-2019), 95.2% were White and 4.8% were Black. Black patients were slightly younger and more frequently (79.5% vs 74.0%) had high-grade carotid artery stenosis compared to White patients. Comorbidities including hypertension, diabetes, kidney disease, congestive heart failure, and coronary artery disease were all more prevalent among Black patients. Crude perioperative stroke and stroke/death were higher for Black patients, but myocardial infarction leading to death were similar. After adjusting for baseline differences between groups, the risk of perioperative stroke and stroke/death remained significantly higher for Black patients than White patients.
Citation: Mallela DP, Canner JK, Zarkowsky DS . Association between race and perioperative outcomes after carotid endarterectomy for asymptomatic carotid artery stenosis in NSQIP. J Am Coll Surg 2022 Jan;234(1):65-73. doi: 10.1097/xcs.0000000000000016..
Keywords: Racial / Ethnic Minorities, Surgery, Cardiovascular Conditions, Stroke, Risk, Adverse Events
Steinberg RS, Nayak A, Burke MA
Association of race and gender with primary caregiver relationships and eligibility for advanced heart failure therapies.
Caregiver support is considered necessary after heart transplant (HT) and left ventricular assist device (LVAD) for patients with end-stage heart failure (HF). Few studies have demonstrated how caregivers differ by gender and race, and whether that impacts therapy eligibility. In this study, the investigators examined caregiver relationships among 674 patients (32% women, 55% Black) evaluated at Emory University from 2011 to 2017.
Citation: Steinberg RS, Nayak A, Burke MA . Association of race and gender with primary caregiver relationships and eligibility for advanced heart failure therapies. Clin Transplant 2022 Jan;36(1):e14502. doi: 10.1111/ctr.14502..
Keywords: Caregiving, Racial / Ethnic Minorities, Heart Disease and Health, Cardiovascular Conditions
Demianczyk AC, Bechtel Driscoll CF, Karpyn A
Coping strategies used by mothers and fathers following diagnosis of congenital heart disease.
This study’s objective was to identify parental coping strategies following diagnosis of congenital heart disease (CHD) and compare use of coping strategies among different groups (mothers vs. fathers, prenatal vs. postnatal diagnosis). A diverse sample of 34 parents (20 mothers and 14 fathers) of young children with CHD participated in semistructured interviews. Parents described using between 1 and 10 different adaptive and maladaptive strategies measured by the COPE Inventory, an instrument that assesses common adult responses to stress. Mothers were more likely than fathers to report a focus on and venting of emotions (70% vs 21.43%) and behavioral disengagement (25% vs. 0%). Parents who had received a prenatal diagnosis described a greater variety of coping strategies compared to parents who received a postnatal CHD diagnosis (6.23 vs 4.52) and more often reported positive reinterpretation and growth, behavioral disengagement, and denial.
Citation: Demianczyk AC, Bechtel Driscoll CF, Karpyn A . Coping strategies used by mothers and fathers following diagnosis of congenital heart disease. Child Care Health Dev 2022 Jan;48(1):129-38. doi: 10.1111/cch.12913..
Keywords: Children/Adolescents, Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions
Wickwire EM, Bailey MD, Somers VK
CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease.
The purpose of this study was to examine the impact of adherence to continuous positive airway pressure (CPAP) therapy on health care utilization among a nationally representative and sample of older adults with multiple morbidities and pre-existing cardiovascular disease and subsequently diagnosed with obstructive sleep apnea in the United States. The investigators concluded that in this nationally representative sample of older Medicare beneficiaries with multiple morbidities and relative to low adherers, high adherers demonstrated reduced inpatient utilization.
Citation: Wickwire EM, Bailey MD, Somers VK . CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease. J Clin Sleep Med 2022 Jan;18(1):39-45. doi: 10.5664/jcsm.9478..
Keywords: Elderly, Medicare, Sleep Problems, Cardiovascular Conditions, Patient Adherence/Compliance, Hospitalization
Shore S, Pienta MJ, Watt TMF
Non-patient factors associated with infections in LVAD recipients: a scoping review.
Infections are the most common complication in recipients of durable left ventricular assist devices (LVAD) and are associated with increased morbidity, mortality, and expenditures. The existing literature examining factors associated with infection in LVAD recipients is limited and principally comprises single-center studies. This scoping review synthesized all available evidence related to identifying modifiable, non-patient factors associated with infections among LVAD recipients.
Citation: Shore S, Pienta MJ, Watt TMF . Non-patient factors associated with infections in LVAD recipients: a scoping review. J Heart Lung Transplant 2022 Jan;41(1):1-16. doi: 10.1016/j.healun.2021.10.006..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Medical Devices
Boehme AK, Oka M, Cohen B
Readmission rates in stroke patients with and without infections: incidence and risk factors.
Investigators examined whether an infection acquired during the initial stroke admission contributed to increased risk of readmission and infection during readmission. Their a retrospective cohort study incorporated all adult ischemic stroke patients 2006-2016 from three New York City hospitals. They found that, among stroke patients, healthcare-associated infections and infections present on admission were predictors of readmission within 60 days and infection during readmission.
Citation: Boehme AK, Oka M, Cohen B . Readmission rates in stroke patients with and without infections: incidence and risk factors. J Stroke Cerebrovasc Dis 2022 Jan;31(1):106172. doi: 10.1016/j.jstrokecerebrovasdis.2021.106172..
Keywords: Stroke, Cardiovascular Conditions, Hospital Readmissions, Risk, Healthcare-Associated Infections (HAIs)
Villa-Zapata L, Carhart BS, Horn JR
Serum potassium changes due to concomitant ACEI/ARB and spironolactone therapy: a systematic review and meta-analysis.
The purpose of this study was to provide evidence of serum potassium changes in individuals taking angiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin receptor blockers (ARBs) concomitantly with spironolactone compared to ACEI/ARB therapy alone. The investigators concluded that treatment with spironolactone in combination with ACEI/ARB therapy increases the mean serum potassium concentration by less than 0.20 mEq/L compared to ACEI/ARB therapy alone.
Citation: Villa-Zapata L, Carhart BS, Horn JR . Serum potassium changes due to concomitant ACEI/ARB and spironolactone therapy: a systematic review and meta-analysis. Am J Health Syst Pharm 2021 Dec 9;78(24):2245-55. doi: 10.1093/ajhp/zxab215..
Keywords: Medication, Comparative Effectiveness, Heart Disease and Health, Cardiovascular Conditions
Williams D, Stout MJ, Rosenbloom JI
Preeclampsia predicts risk of hospitalization for heart failure with preserved ejection fraction.
Preeclampsia is associated with increased risk of future heart failure (HF), but the relationship between preeclampsia and HF subtypes are not well-established. The objective of this analysis was to identify the risk of HF with preserved ejection fraction (HFpEF) following a delivery complicated by preeclampsia/eclampsia. The investigators concluded that preeclampsia/eclampsia was an independent risk factor for future hospitalizations for HFpEF.
Citation: Williams D, Stout MJ, Rosenbloom JI . Preeclampsia predicts risk of hospitalization for heart failure with preserved ejection fraction. J Am Coll Cardiol 2021 Dec 7;78(23):2281-90. doi: 10.1016/j.jacc.2021.09.1360..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Risk, Labor and Delivery, Pregnancy, Women
Kalwani NM, Wang KM, Johnson AN
Application of the quadruple aim to evaluate the operational impact of a telemedicine program.
This study compared the operational impact of a telemedicine program called CardioClick at a preventive cardiology clinic compared to traditional clinic visits. The authors examined data for 134 patients enrolled in CardioClick with 181 video follow-up visits and 276 patients enrolled in the clinic’s traditional program with 694 in-person follow-up visits. The Quadruple Aim was used to evaluate CardioClick. Both cohorts were similar in characteristics in terms of age, gender balance, and baseline clinical characteristics. Video follow-up visits were shorter in time for clinicians (median 22 vs 30 minutes) than in-person visits and total clinic time (median 22 vs 68 minutes). Video visits were more likely to end on time than in-person visits as well. Physicians more often completed video visit documentation on the day of the visit.
Citation: Kalwani NM, Wang KM, Johnson AN . Application of the quadruple aim to evaluate the operational impact of a telemedicine program. Healthc 2021 Dec;9(4):100593. doi: 10.1016/j.hjdsi.2021.100593..
Keywords: Telehealth, Health Information Technology (HIT), Cardiovascular Conditions, COVID-19
Ejem D, Steinhauser K, Dionne-Odom JN
Exploring culturally responsive religious and spirituality health care communications among African Americans with advanced heart failure, their family caregivers, and clinicians.
This study explored how religion and spirituality (R/S) impacts the ways that African Americans (AAs) cope with serious illness. In particular, this study looks at AAs with advanced heart failure and their family caregivers’ (FCGs) preferences about R/S in patient-clinician communication. Transcribed interviews were analyzed to identify emergent themes. AA patient participants (n = 15) were a mean age of 62, 40% female, and 87% had >high school diploma/GED. AA FCGs (n = 14) were a mean age of 58, 93% female, 93% had >high school diploma/GED, and 86% were unemployed. Most caregivers were patients’ spouses/partners. All participants were Protestants. Patients and FCGs perspectives differed in relation to inclusion of R/S in health care communication. Patients felt that R/S should not be discussed in clinical encounters and discussed only if patient initiated. FCGs felt that clinicians’ R/S communication is not a priority, but clinicians should openly acknowledge patients’ R/S beliefs and should engage in R/S conversations with patients.
Citation: Ejem D, Steinhauser K, Dionne-Odom JN . Exploring culturally responsive religious and spirituality health care communications among African Americans with advanced heart failure, their family caregivers, and clinicians. J Palliat Med 2021 Dec;24(12):1798-806. doi: 10.1089/jpm.2021.0044..
Keywords: Racial / Ethnic Minorities, Communication, Heart Disease and Health, Cardiovascular Conditions, Caregiving
Zachrison KS, Schwamm LH, Xu H
Frequency, characteristics, and outcomes of endovascular thrombectomy in patients with stroke beyond 6 hours of onset in US clinical practice.
In 2018, 2 randomized controlled trials showed the benefit of endovascular thrombectomy (EVT) in acute ischemic stroke patients treated 6 to 24 hours from last known well using imaging-guided selection. However, little is known about outcomes in contemporary nontrial settings. In this study, the investigators assessed the frequency of EVT and outcomes beyond 6 hours in the US Get With The Guidelines-Stroke clinical registry.
Citation: Zachrison KS, Schwamm LH, Xu H . Frequency, characteristics, and outcomes of endovascular thrombectomy in patients with stroke beyond 6 hours of onset in US clinical practice. Stroke 2021 Dec;52(12):3805-14. doi: 10.1161/strokeaha.121.034069..
Keywords: Stroke, Cardiovascular Conditions, Surgery, Outcomes