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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 6 of 6 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
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
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
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
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