Rebranding the Perioperative Surgical Home: Lessons From the Duke Experience

Schonberger, Robert B.

doi:10.1053/j.jvca.2016.03.143

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…Programs such as the Perioperative Enhancement Team (POET) at Duke University, have created multidisciplinary teams with the intention of reducing perioperative risk factors by sending their patients to subspecialized clinics for optimization with good results. (19)(20)(21) However, interventions focused on care coordination for newly diagnosed or uncontrolled hypertension have been more limited. (11) The present pilot study demonstrates that preoperative clinic blood pressure interventions are feasible and accepted by most participants, but their impact on blood pressure management is not established.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a Pilot Randomized Hypertension Screening Initiative in the Preoperative Setting.

Díaz

Yan

Dai

et al. 2021

Preprint

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Objectives: This pilot study sought to assess feasibility of a randomized trial of blood pressure intervention (home blood pressure monitoring vs counseling) in the preoperative clinic and the baseline rates of primary care follow-up after such interventions.Methods: A prospective randomized pilot study was performed at Yale New Haven Hospital Preadmission Testing Clinic. A sample of 100 adults with elevated blood pressure, were recruited during their preadmission visit, and randomized 1:1 to receive brief BP counseling and an educational brochure versus additionally receiving a home BP monitor (HBPM) with a mailed report of their home readings. At 60-day post-surgery telephone follow-up, investigators asked whether participants had primary-care follow-up; had new/adjusted hypertension treatment and felt satisfied with the study.Results: There were 51 patients in the counseling group and 49 in the HBPM group. Of 46 patients in the HBPM group who returned their monitors, 36 (78%) were hypertensive at home. At 60 days post-surgery, 31 (61%) patients in the counseling group and 30 (61%) in the HBPM group were reached by telephone with the remaining followed by EMR. 36 (71%) patients in the counseling group and 36 (73%) in the HBPM group had seen their Primary Care provider. 17 of 36 (47%) in the counseling group and 18 of 31 (58%) in the HBPM group received new or adjusted hypertension medications. 61 participants answered questions regarding their satisfaction with the study with 52 (85%) reporting that they felt moderately to very satisfied. Conclusions: This pilot study suggests that interventional blood pressure trials in the preoperative clinic are feasible, but telephone follow-up leads to significant gaps in outcome ascertainment. Trial Registration: Clinicaltrials.gov, NCT03634813. Registered 16 of August 2018, https://clinicaltrials.gov/ct2/show/NCT03634813

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Section: Discussionmentioning

confidence: 99%

Feasibility of a Pilot Randomized Hypertension Screening Initiative in the Preoperative Setting.

Díaz

Yan

Dai

et al. 2021

Preprint

Self Cite

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show abstract

“…Elevated blood pressure is a common, and modifiable cardiovascular disease (CVD) risk factor in patients presenting for surgery. Programs, such as the Perioperative Enhancement Team (POET) at Duke University, have created multidisciplinary teams with the intention of reducing perioperative risk factors by sending their patients to subspecialized clinics for optimization with good results (Aronson 2016 ; Aronson et al 2018 ; Schonberger 2016 ). However, interventions focused on care coordination for newly diagnosed or uncontrolled hypertension have been more limited (Pfister et al 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a randomized hypertension screening initiative in the perioperative setting

et al. 2021

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Objectives This study sought to assess feasibility of a randomized trial of blood pressure intervention (home blood pressure monitoring vs. counseling) in the preoperative clinic and the baseline rates of primary care follow-up after such interventions. Methods A prospective randomized feasibility study was performed at Yale New Haven Hospital Preadmission Testing Clinic. A sample of 100 adults, with elevated blood pressure, were recruited during their preadmission visit, and randomized 1:1 to receive brief BP counseling and an educational brochure versus additionally receiving a home BP monitor (HBPM) with a mailed report of their home readings. At 60-day post-surgery telephone follow-up, investigators asked whether participants had primary-care follow-up; had new/adjusted hypertension treatment; and felt satisfied with the study. Results There were 51 patients in the counseling group and 49 in the HBPM group. Of 46 patients in the HBPM group who returned their monitors, 36 (78%) were hypertensive at home. At 60 days post-surgery, 31 (61%) patients in the counseling group and 30 (61%) in the HBPM group were reached by telephone with the remaining followed by EHR. Thirty-six (71%) patients in the counseling group and 36 (73%) in the HBPM group had seen their primary care provider. Seventeen of 36 (47%) in the counseling group and 18 of 31 (58%) in the HBPM group received new or adjusted hypertension medications. Sixty-one participants answered questions regarding their satisfaction with the study with 52 (85%) reporting that they felt moderately to very satisfied. Conclusions This feasibility study suggests that interventional blood pressure trials in the preoperative clinic are feasible, but telephone follow-up leads to significant gaps in outcome ascertainment. Trial registration Clinicaltrials.gov, NCT03634813. Registered 16 of August 2018.

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“…For these reasons, the American Heart Association (AHA) recently released a scientific statement specifically addressing MINS with more robust recommendations greatly affecting anesthesiologists as perioperative specialists. 1,4…”

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confidence: 99%

Increasing the Perioperative Specialists Role: Comment on the 2021 American Heart Association Scientific Statement on Myocardial Injury After Noncardiac Surgery

Gessouroun

Flynn

2022

Journal of Cardiothoracic and Vascular Anesthesia

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Rebranding the Perioperative Surgical Home: Lessons From the Duke Experience

Cited by 7 publications

References 17 publications

Feasibility of a Pilot Randomized Hypertension Screening Initiative in the Preoperative Setting.

Feasibility of a Pilot Randomized Hypertension Screening Initiative in the Preoperative Setting.

Feasibility of a randomized hypertension screening initiative in the perioperative setting

Increasing the Perioperative Specialists Role: Comment on the 2021 American Heart Association Scientific Statement on Myocardial Injury After Noncardiac Surgery

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