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- (-) Cardiovascular Conditions (10)
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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 10 of 10 Research Studies DisplayedKimchi A, Aronow HU, Ni YM
Postdischarge noninvasive telemonitoring and nurse telephone coaching improve outcomes in heart failure patients with high burden of comorbidity.
The purpose of this study was to explore how comorbidity burden modulates the effectiveness of Noninvasive telemonitoring and nurse telephone coaching (NTM-NTC) and identify patients with HF who may benefit from postdischarge NTM-NTC based on their burden of comorbidity. METHODS AND RESULTS: In the Better Effectiveness After Transition - Heart Failure trial, patients hospitalized for acute decompensated HF were randomized to postdischarge NTM-NTC or usual care. In this secondary analysis of 1313 patients with complete data, comorbidity burden was assessed by scoring complication and coexisting diagnoses from index admissions. Clinical outcomes included 30-day and 180-day readmissions, mortality, days alive, and combined days alive and out of the hospital. Patients had a mean of 5.7 comorbidities and were stratified into low (0-2), moderate (3-8), and high comorbidity (≥9) subgroups. Increased comorbidity burden was associated with worse outcomes. NTM-NTC was not associated with readmission rates in any comorbidity subgroup. Among high comorbidity patients, NTM-NTC was associated with significantly lower mortality at 30 days (hazard ratio 0.25, 95% confidence interval 0.07-0.90) and 180 days (hazard ratio 0.51, 95% confidence interval 0.27-0.98), as well as more days alive (160.1 vs 140.3, P = .029) and days alive out of the hospital (152.0 vs 133.2, P = .044) compared with usual care. CONCLUSIONS: Postdischarge NTM-NTC improved survival among patients with HF with a high comorbidity burden. Comorbidity burden may be useful for identifying patients likely to benefit from this management strategy.
AHRQ-funded; HS019311.
Citation: Kimchi A, Aronow HU, Ni YM .
Postdischarge noninvasive telemonitoring and nurse telephone coaching improve outcomes in heart failure patients with high burden of comorbidity.
J Card Fail 2023 May; 29(5):774-83. doi: 10.1016/j.cardfail.2022.11.012..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT), Hospital Discharge
Ofoma UR, Drewry AM, Maddox TM
Outcomes of in-hospital cardiac arrest among hospitals with and without telemedicine critical care.
This study compared survival rates for inpatients who suffered in-hospital cardiac arrest (IHCA) who had access to Telemedicine Critical Care (TCC) during nights and weekends (off-hours) compared to those who did not. The authors identified 44,585 adults at 280 U.S. hospitals in the Get With The Guidelines® - Resuscitation registry who suffered IHCA in an Intensive Care Unit (ICU) or hospital ward between July 2017 and December 2019. The majority (60.6%) of IHCAs occurred in an ICU, and 32.2% participants suffered IHCA at hospitals with TCC. No difference was found in acute resuscitation survival rates or survival to discharge rates for either IHCA between TCC and non-TCC hospitals. Timing of cardiac arrest did not modify the association between TCC availability and acute resuscitation survival or survival to discharge.
AHRQ-funded; HS019455.
Citation: Ofoma UR, Drewry AM, Maddox TM .
Outcomes of in-hospital cardiac arrest among hospitals with and without telemedicine critical care.
Resuscitation 2022 Aug;177:7-15. doi: 10.1016/j.resuscitation.2022.06.008..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT), Outcomes, Critical Care, Intensive Care Unit (ICU)
Wells R, Dionne-Odom JN, Azuero A
Examining adherence and dose effect of an early palliative care intervention for advanced heart failure patients.
The objective of this study was to examine the "dose" effect of PC intervention completion vs. noncompletion on quality of life (QoL) and healthcare use in patients with advanced heart failure (HF) over 32 weeks. The investigators concluded that higher intervention completion rates of an early PC intervention was associated with QoL improvements in patients with advanced HF.
AHRQ-funded; HS013852.
Citation: Wells R, Dionne-Odom JN, Azuero A .
Examining adherence and dose effect of an early palliative care intervention for advanced heart failure patients.
J Pain Symptom Manage 2021 Sep;62(3):471-81. doi: 10.1016/j.jpainsymman.2021.01.136..
Keywords: Palliative Care, Heart Disease and Health, Cardiovascular Conditions, Quality of Life, Telehealth, Health Information Technology (HIT)
Shah NR, Eisman AS, Winchester DE
E-consult protocoling to improve the quality of cardiac stress tests.
Rarely appropriate cardiac stress tests remain prevalent in the range of 10% to 20% and unnecessarily prolong wait times. To address this ongoing problem, the investigators designed the EPIQ-Stress workflow, which included a structured electronic consult (“econsult”) with all outpatient stress test orders. In this study, the investigators assessed whether EPIQ-Stress implementation was associated with a reduction in rarely appropriate testing and in order-to-report wait times.
AHRQ-funded; HS022998.
Citation: Shah NR, Eisman AS, Winchester DE .
E-consult protocoling to improve the quality of cardiac stress tests.
JACC Cardiovasc Imaging 2021 Feb;14(2):512-14. doi: 10.1016/j.jcmg.2020.08.009..
Keywords: Telehealth, Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality
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
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)
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
Baik D, Reading M, Jia H
Measuring health status and symptom burden using a web-based mHealth application in patients with heart failure.
This cross-sectional study was conducted at an urban academic medical center to measure health status and symptom burdens of heart failure patients using a mHealth application called mi.Symptoms. Patients were diverse, with a mean age of 58.7, and were 37% women, 36% Black, and 36% Hispanic/Latino. Almost half were classified as New York Heart Association class III, and 44% reported not having enough income to make ends meet. Health status was measured with the Kansas City cardiomyopathy questionnaire clinical summary score. Predictors of better health status included higher physical function and ability to participate in social functions and activities. Predictors of poorer health status was New York Heart Association class IV status and dyspnea.
AHRQ-funded; HS021816.
Citation: Baik D, Reading M, Jia H .
Measuring health status and symptom burden using a web-based mHealth application in patients with heart failure.
Eur J Cardiovasc Nurs 2019 Apr;18(4):325-31. doi: 10.1177/1474515119825704..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Health Status, Telehealth, Health Information Technology (HIT)
Masterson Creber RM, Hickey KT, Maurer MS
Gerontechnologies for older patients with heart failure: what is the role of smartphones, tablets, and remote monitoring devices in improving symptom monitoring and self-care management?
The authors discussed the role of gerontechnologies, specifically the use of mobile applications available on smartphones and tablets as well as remote monitoring systems, for outpatient disease management among older adults with heart failure.
AHRQ-funded; HS021816.
Citation: Masterson Creber RM, Hickey KT, Maurer MS .
Gerontechnologies for older patients with heart failure: what is the role of smartphones, tablets, and remote monitoring devices in improving symptom monitoring and self-care management?
Curr Cardiovasc Risk Rep 2016 Oct;10(10). doi: 10.1007/s12170-016-0511-8.
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Keywords: Elderly, Telehealth, Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions, Patient Self-Management
Black JT, Romano PS, Sadeghi B
A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better
The objective of this randomized controlled comparative effectiveness study was to evaluate the effectiveness of a care transition intervention that included pre-discharge education about heart failure and post-discharge telephone nurse coaching combined with home telemonitoring of weight, blood pressure, heart rate, and symptoms in reducing all-cause 180-day hospital readmissions for older adults hospitalized with heart failure.
AHRQ-funded; HS019311.
Citation: Black JT, Romano PS, Sadeghi B .
A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better
Trials 2014 Apr 13;15:124. doi: 10.1186/1745-6215-15-124..
Keywords: Cardiovascular Conditions, Comparative Effectiveness, Health Information Technology (HIT), Heart Disease and Health, Hospital Readmissions, Telehealth, Transitions of Care