Laying the Groundwork for Better Heart Health in 2020 and Beyond

FEB

2020

Bob McNellis, M.P.H., P.A., and

Michael I. Harrison, Ph.D.

A healthy human heart beats at the center of a healthy life. We are reminded every February, during American Heart Month, that we must continue our work to curb the biggest contributors to heart disease—high blood pressure, high blood cholesterol, tobacco use, unhealthy diets, and physical inactivity.

We have reported on AHRQ’s efforts in the past. But this year, perhaps more than any other, we are thrilled to provide updates on the impressive strides that AHRQ has taken in the last year to broaden our support of heart health. These new and expanded initiatives will have lasting impacts on decreasing premature deaths due to heart disease by increasing the number of people who take care of their hearts.

Let’s start by highlighting an exciting AHRQ project launched last spring: the TAKEheart initiative. Currently, only 1 in 5 of eligible patients with serious cardiac conditions enroll in cardiac rehabilitation (CR), which has been shown to improve health and prevent hospital readmissions. TAKEheart takes aim at these missed opportunities by spreading two evidence-based practices shown to boost rates of CR referral of eligible patients. These strategies involve automatically referring patients to CR through electronic health record prompts and ensuring that a staff member or lay navigator helps coordinate the patient’s referral process.

Recently, TAKEheart reached an important milestone. We’ve recruited the first of two waves of 50 hospitals and have begun the training and support needed for implementing automatic electronic referral to CR as well as care coordination. AHRQ’s newly launched TAKEheart website provides access to rich resources for hospitals seeking to implement evidence-based strategies to increase CR participation. Recruitment is also underway to build a learning community of up to 200 hospitals to support peer-to-peer learning about cutting-edge CR topics, such as home-based rehabilitation and reducing disparities in rehabilitation rates. Initiatives like TAKEheart not only improve the health of the patients involved, but also allow AHRQ to learn how best to grow and expand evidence-based interventions, like CR, that can greatly improve the Nation’s health.

TAKEheart is part of AHRQ’s continuing, close collaboration with the Million Hearts® initiative. Launched by the Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services, Million Hearts® utilizes a network of partners focused on preventing one million heart attacks, strokes, and other cardiovascular disease events by 2022.

AHRQ’s alignment with Million Hearts® runs deep. Through the Agency’s EvidenceNOW initiative, AHRQ has helped more than 1,500 small- and medium-sized primary care practices across the country use the latest evidence to improve the heart health of millions of Americans. EvidenceNOW is having a positive impact on practices and their patients. The results are still emerging, but it’s clear that working closely with primary care practices and clinicians to help them use the best evidence has the potential to lead to meaningful improvements in blood pressure control and smoking cessation. Some practices have demonstrated extraordinary improvements; consider, for example, that 30 percent of the Million Hearts® Hypertension Control Champions between 2017 and 2019 were practices enrolled in EvidenceNOW. Congratulations to those practices and their patients!

In the coming days, AHRQ will launch a new initiative to build on lessons learned from EvidenceNOW that will be focused on improving the heart health of people in communities with the greatest need. Project participants will be developing State-level capacity to broaden the dissemination and implementation of patient-centered outcomes research findings into even more primary care practices throughout the United States. This effort to further improve heart health and capitalize on new multi-organizational partnerships is designed to establish and expand the capacity of sustainable, primary care quality improvement. Stay tuned!

Heart disease is rarely the only health issue that needs to be addressed. Many people with heart problems also need care for other chronic diseases, and healthcare professionals can be challenged to help patients effectively manage multiple chronic conditions. AHRQ has a multi-year plan to study and implement new approaches for caring for patients with multiple chronic conditions. These approaches aim to promote health and function, reduce the burden of illness, minimize the burden of treatment on patients and caregivers, and support patient goals. One potential approach is expanded use of care plans, which can be particularly valuable for patients with heart disease as they transition between their primary care practice and their cardiology practice, especially following a hospital discharge.

Whether you are working to prevent heart disease, trying to improve recovery after a cardiac event or procedure, or managing heart disease as one part of taking care of the whole patient, know that AHRQ continues to be your partner with the research, tools, and data to help ensure healthy human hearts beat long and strong.

Bob McNellis is AHRQ’s Senior Advisor for Primary Care.

Michael Harrison is a Senior Social Scientist at AHRQ.