PCORI Answers Critical Questions
Evidence gaps can make it difficult to know which cardiovascular disease treatment will work best given a patient’s needs. PCORI funds studies that seek to help patients, clinicians and others answer various questions they might have about treatment options, such as:
Patient: I want to avoid having another deep-vein blood clot. Which of the many blood-thinning drugs would be most safe and effective for me over the long term?
Caregiver: My 85-year-old father is leaving the hospital after surviving a stroke. What drug would work best for him to avoid another hospital stay or need to go into a nursing home?
Clinician: How can I best help my patients in this small rural town get their blood pressure under control and avoid heart attacks and strokes?
Study Results that Support Better-Informed Decisions
Although chest pain sends many people to emergency departments, a significant percentage are not having a heart attack or other serious heart problem. Patients who used a decision aid were more knowledgeable about their risk and care options and more involved in decisions about whether to be admitted to the hospital or go home, the Chest Pain Choice Trial found.
A heart implant called a left ventricular assist device (LVAD) can prolong the lives of people with severe heart failure, but it’s also associated with significant risk for harms, making choosing whether to have one implanted very difficult, according to an article in JAMA Internal Medicine. Using a shared decision making tool focused on LVAD improved patients’ knowledge about their treatment options and risks, this study found, and helped them make initial decisions better aligned with their values.
When patients at risk for developing a potentially fatal blood clot during a hospital stay missed a dose of drugs that can reduce this risk, receiving educational information about the drugs—through a conversation with a provider or a video or printed pamphlet—significantly increased the chances they got all their necessary doses, this study showed. The findings have been published in JAMA Network Open.
Using the blood-thinning medicine warfarin enabled stroke survivors, even those over 80, to continue living in their homes longer compared with those who didn’t take the drug, the PROSPER study found. Those taking the drug stayed in their homes on average 46 more days during the two years after being hospitalized for stroke. Continuing medical education is available on these findings.
For at least one year after treatment, a nonsurgical method to replace a damaged heart valve was as safe as the surgery conventionally used in patients at moderate or high risk for surgical complications, this study determined. Moreover, compared with surgery, the nonsurgical approach allowed more patients to go directly home from the hospital, rather than to a nursing home or rehabilitation facility. That’s an outcome the study’s patient partners had identified as particularly important.
Cardiovascular Disease Study Spotlights
People who have had a blood clot are at high risk of having another. This study is comparing the benefits and risks of three blood-thinning medicines for people who take them on a long-term basis.
About one in three American adults has hypertension, or high blood pressure (HBP). This study is comparing two methods of monitoring HBP to determine whether telehealth offers an edge over more traditional clinic-based care.
This study is comparing the comfort, convenience, and effects on health when people with hypertension have their blood pressure measured in clinics, at home, at automated blood pressure measuring kiosks, and by wearing an arm cuff with a monitor for 24 hours.