Digital Care Transformation

Scirica, Benjamin M.; Cannon, Christopher P.; Fisher, Naomi D.L.; Gaziano, Thomas A.; Zelle, David; Chaney, Kira; Miller, Angela; Nichols, Hunter; Matta, Lina; Gordon, William J.; Murphy, Shawn N.; Wagholikar, Kavi B.; Plutzky, Jorge; MacRae, Calum A.

doi:10.1161/circulationaha.120.051913

Cited by 45 publications

(24 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other meta-analyses showed that pharmacist-led interventions improved lipid-lowering therapy adherence by 67% [66 ▪ ] and significantly reduced LDL by 15 mg/dL [67 ▪▪ ]. In the remote, team-based management program described earlier, the navigator and pharmacist-led intervention also demonstrated a mean LDL reduction of 24 mg/ dL among enrolled patients and 52 mg/dL in patients who achieved maintenance after completing titration [61 ▪▪ ]. Also, the use and titration of all lipid-lowering therapies improved significantly.…”

Section: Team-based Interventions To Control Modifiable Risk Factorsmentioning

confidence: 87%

“…More recent, innovative team-based approaches to BP control utilized patient navigators and pharmacists supervised by physicians to initiate and titrate medications based on standardized algorithms among individuals with uncontrolled BP in an entirely remote fashion [61 ▪▪ ]. This intervention significantly reduced systolic and diastolic BP by 14 and 6 mm Hg, respectively, compared to baseline levels.…”

Section: Team-based Interventions To Control Modifiable Risk Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Team-based strategies to prevent heart failure

Taha

Patel

Nasir

2022

Current Opinion in Cardiology

View full text Add to dashboard Cite

Purpose of reviewThe burden of heart failure (HF) in the United States and worldwide is projected to rise. Prevention of HF can curb the burden of this chronic syndrome, but current approaches are limited. This review discusses team-based strategies aimed to prevent HF.Recent findingsIndividuals at high risk for developing HF can be identified using HF risk scores, biomarkers, and cardiac imaging. Electronic medical records (EMR) can integrate clinical data to estimate HF risk and identify individuals who may benefit most from preventive therapies. Team-based interventions can lead to enhanced adherence to medications, optimization of medical management, and control of risk factors. Multifaceted interventions involve EMR-based strategies, pharmacist- and nurse-led initiatives, involvement of community personnel, polypills, and digital solutions.SummaryTeam-based strategies aimed to prevent HF incorporate a broad group of personnel and tools. Despite implementation challenges, existing resources can be efficiently utilized to facilitate team-based approaches to potentially reduce the burden of HF.

show abstract

Section: Team-based Interventions To Control Modifiable Risk Factorsmentioning

confidence: 87%

Section: Team-based Interventions To Control Modifiable Risk Factorsmentioning

confidence: 99%

Team-based strategies to prevent heart failure

Taha

Patel

Nasir

2022

Current Opinion in Cardiology

View full text Add to dashboard Cite

show abstract

“…45 A protocolized approach to subsequent medication intensification is advisable to achieve treatment goals efficiently and at scale. 46,47 For an interventional treatment such as RDN, peer support networks for patients may be a helpful tool allowing patients to benefit from adequate information and expectations.…”

Section: Multidisciplinary Evaluation and Treatment Decision-makingmentioning

confidence: 99%

“…A highly important objective is to generate a feedback loop with patients, for example, by enabling them to submit BP readings on a regular basis to inform treatment decisions 45 . A protocolized approach to subsequent medication intensification is advisable to achieve treatment goals efficiently and at scale 46,47 . For an interventional treatment such as RDN, peer support networks for patients may be a helpful tool allowing patients to benefit from adequate information and expectations.…”

Section: Multidisciplinary Evaluation and Treatment Decision‐makingmentioning

confidence: 99%

Renal denervation in hypertension patients: Proceedings from an expert consensus roundtable cosponsored by SCAI and NKF

Kandzari

Townsend

Bakris

et al. 2021

Cathet Cardio Intervent

View full text Add to dashboard Cite

Despite the availability of efficacious pharmacological treatments, hypertension remains the leading global cause of death and disability, 1 and rates of blood pressure (BP) control are stagnant, if not modestly declining. In the United States alone, for example, more than one-half of individuals with hypertension do not meet societal or guideline-directed BP goals, representing more than 29 million people. 2,3 Although reasons are multifactorial, patient non-adherence, physician inertia, as well as barriers such as lack of social support, depression and complex polypharmacy regimens are major contributors to lack of BP goal achievement.Interventional strategies, such as catheter-based renal denervation (RDN) using radiofrequency energy, ultrasound, or perivascular injection of neurotoxic agents, are gaining increasing attention. The rationale for RDN is to interrupt the activity of afferent and efferent

show abstract

“…In Reply We appreciate the comments in support of our work by Karamat and colleagues and agree that the remote, algorithm-driven, navigator-led and pharmacist-led approach we used to optimize guideline-directed medical therapy for patients with heart failure and reduced ejection fraction can be readily adapted to implementation at scale or to management of other cardiovascular conditions. Indeed, additional work from our group has already highlighted that this strategy may be effective as a health care system–level intervention to improve control of lipids and blood pressure in accordance with guideline-recommended targets . Validation of these results in other clinical contexts along with longer-term follow-up to confirm the anticipated favorable effects on clinical outcomes and health care utilization may be needed to encourage broader adoption of this approach to cardiovascular risk reduction in clinical practice.…”

mentioning

confidence: 99%

An Excellent Model to Increase Adherence to Guideline-Directed Medical Therapy—With Far-reaching Implications—Reply

Desai

2021

JAMA Cardiol

View full text Add to dashboard Cite

posed a population-level measure called "healthy days at home" to measure performance across accountable care organizations as well as MA plans. 3p211 These measures, which bring time spent at home to the forefront, are easily understood by patients and families. In addition, they are also correlated with other heart failure quality measures-like readmissions and mortality 4 -and better capture the burden of the disease on the health care system. However, before using measures of time at home to assess performance, there are important issues to consider. For one, more time at home does not always reflect higher quality of care. For instance, some patients may benefit from rehabilitation to improve their functional status, exercise capacity, and quality of life. 5 The use of such a measure might inadvertently encourage lower use of rehabilitation among appropriate patients who may benefit from it. Furthermore, the ability of patients to stay safely at home depends on numerous factors, including availability of appropriate support at home and financial resources. Therefore, any measure that incentivizes clinicians to send more patients home must account for social determinants of health.

show abstract

Digital Care Transformation

Cited by 45 publications

References 5 publications

Team-based strategies to prevent heart failure

Team-based strategies to prevent heart failure

Renal denervation in hypertension patients: Proceedings from an expert consensus roundtable cosponsored by SCAI and NKF

An Excellent Model to Increase Adherence to Guideline-Directed Medical Therapy—With Far-reaching Implications—Reply

Contact Info

Product

Resources

About