Cardiovascular Disease Clinical Trial
Official title:
Heart Health NOW (Previously Known as Facilitation, Spread, and Translation of Patient-Centered Evidence in North Carolina Practices)
The objective of this study is to determine if primary care practice support accelerates the dissemination and implementation of patient-centered outcome results (PCOR) findings to improve heart health and increases primary care practices' capacity to incorporate other PCOR findings in the future.
The burden of cardiovascular disease in North Carolina remains large. The latest data
available show an annual cardiovascular death rate of 263 per 100,000 explaining almost
one-third of deaths in the state. Disease progression is largely determined by several risk
factors including elevated blood pressure or cholesterol, not using aspirin for prevention,
and tobacco use. Primary care practices as currently organized have been unable to get more
than half these patients to achieve recommended targets for risk factor reduction. Small
independent practices, in particular, lack resources for enhanced practice support to improve
cardiovascular care.
This study will enroll 300 primary care practices to evaluate the effect of primary care
support on evidence-based cardiovascular disease (CVD) prevention and organizational change
process measures. Each practice will start the trial as a control, receive the intervention
at a randomized time point, and then enter a maintenance period 12 months after starting the
intervention. All practices will receive 12 months of the intense intervention including
onsite quality improvement (QI) facilitation, academic detailing, electronic health record
(EHR) support, and, through the North Carolina Health Information Exchange (HIE), a shared
statewide utility providing whole population analytics, care gap identification,
benchmarking, and an external reporting mechanism which otherwise would not be available to
independent practices.
A successful intervention would prove that practice facilitation supported by effective
informatics tools is an effective method of translating PCOR findings into practice.
Discernible reductions in cardiovascular risk in 300 practices covering over an estimated
900,000 adult patients would likely lead to prevention of thousands of cardiovascular events
within 10 years.
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