Abstract:
BACKGROUND:Treatment with specific beta-blockers and doses recommended by guidelines is often not achieved in practice. We evaluated an intervention directed to the pharmacy to improve prescribing. METHODS AND RESULTS:We conducted a pragmatic cluster-randomized trial, where facilities (n = 12) with patients (n = 220) were the clusters. Eligible patients had a beta-blocker prescription that was not guideline concordant. Level 1 intervention included information to a pharmacist on facility guideline concordance. Level 2 also provided a list of patients not meeting guideline goals. Intervention and follow-up periods were each 6 months. Achievement of full concordance with recommendations was low (4%-5%) in both groups, primarily due to lack of tolerability. However, compared with level 1, the level 2 intervention was associated with 1.9-fold greater odds of improvement in prescribing (95% confidence interval [CI] 1.1-3.2). Level 2 patients also had greater odds of a higher dose (1.9, 95% CI 1.1-3.3). The intervention was aided by the patient lists provided, the electronic medical record system, and staff support. CONCLUSIONS:In actual practice, full achievement of guideline goals was low. However, a simple intervention targeting pharmacy moved patients toward guideline goals. As health care systems incorporate electronic medical records, this intervention should have broader feasibility.
journal_name
J Card Failjournal_title
Journal of cardiac failureauthors
McCarren M,Furmaga E,Jackevicius CA,Sahay A,Coppler TL,Katzianer J,Griffiths RL,Tonnu-Mihara I,Heidenreich Pdoi
10.1016/j.cardfail.2013.06.004subject
Has Abstractpub_date
2013-08-01 00:00:00pages
525-32issue
8eissn
1071-9164issn
1532-8414pii
S1071-9164(13)00192-9journal_volume
19pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Exercise training is included in cardiac rehabilitation programs to enhance physical capacity and cardiovascular function. Among the existing rehabilitation programs, exercises in water are increasingly prescribed. However, it has been questioned whether exercises in water are safe and relevant in patients w...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.cardfail.2011.04.008
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus (DM) is a risk factor for mortality among patients with heart failure as well as for patients who undergo cardiothoracic surgery. However it is unknown whether DM is associated with increased mortality or major complications during continuous-flow left ventricular assist device (CF-LVAD) su...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2016.02.010
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Phosphodiesterase-5A inhibitors (PDE5i) are sometimes used in patients with advanced heart failure with reduced ejection fraction before heart transplant or left ventricular assist device implantation to decrease right ventricular (RV) afterload and mitigate the risk of right heart failure. Conflicting evide...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2020.11.007
更新日期:2020-11-21 00:00:00
abstract:BACKGROUND:Telemonitoring has been advocated as a way of decreasing costs and improving outcomes, but no study has looked at true Medicare payments and 30-day readmission rates in a randomized group of well treated patients. OBJECTIVE:The aim of this work was to analyze Medicare claims data to identify effects of home...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.cardfail.2014.04.016
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:A link between diabetes mellitus (DM) and heart failure (HF) has been well-recognized for more than a century. HF is also closely linked to abnormal glucose regulation (AGR) and insulin resistance (IR) in patients without DM and, similarly, these conditions commonly coexist. In epidemiological studies, each ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,评审
doi:10.1016/j.cardfail.2010.05.027
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Disease-modifying drug treatment in heart failure (HF) reduces blood pressure. Titration of these agents is guided by clinic blood pressure readings; however, the impact of such treatment on blood pressure is unknown because diurnal blood pressure patterns remain poorly described. The aim of this study was t...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2008.03.003
更新日期:2008-09-01 00:00:00
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journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2012.08.001
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Studies of animal models and human subjects with cardiomyopathies suggest that cardiac myocyte and ventricular chamber remodeling show distinct phenotypic characteristics that may be dependent on specific signaling pathways. METHODS AND RESULTS:In this study, we characterize right ventricular (RV) chamber s...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/s1071-9164(99)90024-6
更新日期:1999-03-01 00:00:00
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journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1054/jcaf.2003.47
更新日期:2003-08-01 00:00:00
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journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1054/jcaf.2002.125369
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Anemia is associated with higher morbidity and mortality in patients with heart failure (HF), but its implications for heath care costs are not well described. METHODS AND RESULTS:We analyzed data on 1056 patients with symptomatic HF seen at Duke University between 2002 and 2006. Health care costs were obta...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2009.06.435
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Wolff-Parkinson-White (WPW) has been associated with left ventricular noncompaction (LVNC) in children. Little is known about the prevalence of this association, clinical outcomes, and treatment options. METHODS:Retrospective review of subjects with LVNC. LVNC was defined by established criteria; those with...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2019.09.014
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Heightened activity of the sympathetic nervous system in heart failure patients is a major contributor to disease progression and death. I-123 metaiodobenzylguanidine (MIBG) provides an accurate, noninvasive method to assess cardiac sympathetic nerve activity. METHODS:Thirty-seven patients with New York Hea...
journal_title:Journal of cardiac failure
pub_type: 临床试验,杂志文章
doi:10.1054/s1071-9164(03)00134-9
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Cardiac magnetic resonance (CMR) imaging is an established method of detecting myocardial fibrosis related to prognosis in patients with dilated cardiomyopathy (DCM). Recent studies have found that (99m)Tc-methoxy-isobutyl-isonitrile (MIBI) and (123)I-15-(p-iodophenyl)-3(R,S)-methylpentadecanoic acid (BMIPP)...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2013.05.009
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Empirical evidence supporting the benefits of dietary recommendations for patients with advanced heart failure is scarce. We prospectively evaluated the relation of dietary habits to pre-transplant clinical outcomes in the multisite observational Waiting for a New Heart Study. METHODS AND RESULTS:A total of...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,多中心研究
doi:10.1016/j.cardfail.2013.02.004
更新日期:2013-04-01 00:00:00
abstract::Carfilzomib is a novel irreversible proteasome inhibitor (PI) used with increasing frequency to treat patients with relapsed and/or refractory multiple myeloma (RRMM). This agent is an effective treatment for this challenging population, but proteasome inhibition has the potential of significant cardiac toxicity via t...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2014.11.008
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:We sought to systematically combine the evidence on efficacy of disease management programs (DMPs) in the treatment of congestive heart failure (CHF), to identify and explain heterogeneity of results from prior studies of DMPs, and to assess potential publication bias from these studies. METHODS AND RESULTS...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.cardfail.2006.03.003
更新日期:2006-09-01 00:00:00
abstract::Diuretic resistance in heart failure is defined as a state in which diuretic response is diminished or lost before the therapeutic goal of relief from congestion has been reached. Diuretic resistance is very common and is associated with poor outcomes. Over the past decade, several new drugs and devices targeting deco...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,评审
doi:10.1016/j.cardfail.2014.06.353
更新日期:2014-09-01 00:00:00
abstract::The complexity of standard medical treatment for heart failure is growing, and such therapy typically involves 5 or more different medications. Given these pressures, there is increasing interest in harnessing cardiovascular biomarkers for clinical application to more effectively guide diagnosis, risk stratification, ...
journal_title:Journal of cardiac failure
pub_type:
doi:10.1016/j.cardfail.2013.05.012
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Improvement of left ventricular (LV) systolic dysfunction can occur in patients with dilated cardiomyopathy (DCM), and it is more frequently observed if patients have no delayed enhancement (DE) in cardiac magnetic resonance imaging (CMR). However, even in the absence of DE, not all patients have functional ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2015.12.011
更新日期:2016-04-01 00:00:00
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journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2018.05.003
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Differentiating between constrictive pericarditis (CP) and restrictive cardiomyopathy (RCMP) is difficult because of similar clinical and hemodynamic presentation. Brain natriuretic peptide (BNP) has been reported a useful noninvasive biomarker to differentiate CP from RCMP; however, its utility in patients ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2007.05.001
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Our aim was to study the potential effect of neighborhood deprivation on incident heart failure (HF) in patients with diabetes mellitus (DM). METHODS:The study population included adults (n = 434,542) aged 30 years or older with DM followed from 2005 to 2015 in Sweden for incident HF. The association betwee...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2019.04.017
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Survival of patients with congenital heart defects including increased right ventricular pressure load (ie, tetralogy of Fallot) or pulmonary hypertension is dependent on the function of the right ventricle (RV). RV remodeling has several effects with progressive transition from compensated status to heart f...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2020.02.006
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Many approaches have been considered to reduce heart failure (HF) readmissions. The Joint Commission on Accreditation of Health Care Organizations (JC) requires hospitals to provide patients admitted for HF with discharge instructions that address 6 topics related to HF management: diet, exercise, weight mon...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2014.06.358
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Current US and European guidelines recommend that ejection fraction (EF) be measured at least once in patients with congestive heart failure (CHF). However, it is not known how age and sex influence adherence to this recommendation. METHODS:We reviewed a national sample of Medicare patients discharged with ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1054/jcaf.2003.16
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:In the current era, where advanced heart failure (AHF) has become an American Board of Internal Medicine-certified subspecialty, new data are needed to benchmark and value levels of clinical effort performed by AHF specialists (AHFMDs). METHODS AND RESULTS:A 36-question survey was sent to 728 AHFMDs, member...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2015.08.340
更新日期:2015-11-01 00:00:00
abstract::Heart failure (HF) is a syndrome characterized by high mortality, frequent hospitalization, reduced quality of life, and a complex therapeutic regimen. Knowledge about HF is accumulating so rapidly that individual clinicians may be unable to readily and adequately synthesize new information into effective strategies o...
journal_title:Journal of cardiac failure
pub_type: 杂志文章,实务指引
doi:10.1016/j.cardfail.2005.11.005
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Clinical multistage risk assessment associated with electrocardiogram (ECG) and NT-proBNP may be a feasible strategy to screen hypertrophic cardiomyopathy (HCM). We investigated the effectiveness of a screening based on ECG and NT-proBNP in first-degree relatives of patients with HCM. METHODS AND RESULTS:A ...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2012.04.005
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:The objective of this study was to determine whether participation in a quality improvement (QI) collaborative for heart failure (HF) was associated with better interpersonal aspects of care and health outcomes. METHODS AND RESULTS:We conducted a cross-sectional telephone survey of patients in 6 organizatio...
journal_title:Journal of cardiac failure
pub_type: 杂志文章
doi:10.1016/j.cardfail.2005.03.010
更新日期:2005-08-01 00:00:00