AHRQ’s EvidenceNOW Initiative: Reducing Primary Care Patients’ Risk of Heart Attacks

By Dr. David Meyers, Chief Medical Officer of AHRQ
Twitter: @AHRQNews

One of the greatest joys of being a family physician is celebrating with patients who have set a health goal and achieved it—the new father who quit smoking, the busy teacher who made the time to get back in shape and who completed her first 5K race, the grandmother who committed to getting her diabetes under control and proudly shares with me her outstanding glucose logs.

At AHRQ, our ‘patients’ are often whole primary care practices. We partner with them to help them improve their health care, similar to how they partner with their patients to improve their health. With our EvidenceNOW initiative, AHRQ is working with more than 1,500 primary care practices to assist them in improving the delivery of services proven to prevent heart attacks and strokes. These include the “ABCS” of heart health—Aspirin use by high-risk individuals, Blood pressure control, Cholesterol management, and Smoking cessation.

This February, as the Nation commemorates American Heart Month, we at AHRQ are celebrating the successes of many EvidenceNOW practices in reaching and surpassing their health care goals:

• With support from EvidenceNOW, East Asheville Family Health Care in North Carolina has adopted a new workflow so that staff can calculate each patient’s heart disease risk score. As a result, in the first 8 months of 2017, 230 patients were newly prescribed a statin medication to help them reduce their chance of having a heart attack. Another 368 were prescribed aspirin. “It’s very powerful” for patients to see their risk of a heart attack over the next 10 years,” said Dr. James Early, who heads the practice. “Using scores is a real innovation. I see it as a major advance in how to take care of people in the future.”
• Clinics in Oklahoma are now better able to troubleshoot a variety of day-to-day challenges, including data extraction and electronic health record (EHR) use. Through EHR training and guidance from EvidenceNOW, one clinic’s care team increased their rate of blood pressure measurement from 49 percent to 82 percent among patients at risk for stroke or heart attack. The practice doubled the number of patients identified with hypertension.
• Cascades East practice in Klamath Falls, Oregon, received support to use their EHR to track whether patients who smoke received smoking cessation counseling. As a result of the team’s efforts, in just 3 months the practice’s rate of offering smoking cessation counseling rose from 12 percent to 70 percent!

In addition to these successes, five practices participating in EvidenceNOW were among the 24 national 2017 Million Hearts® Hypertension Control Champions. These practices helped more than 70 percent of their patients achieve blood pressure control through innovations in patient communication, health information technology use, and team-based approaches to care.

AHRQ is proud to be working with the national Million Hearts® initiative, joining the movement to help Americans control risk factors for heart disease. The potential payoff is enormous. Heart disease remains the Nation’s number one killer, accounting for one of every four deaths. But research shows that controlling risks can reduce the chances of heart attack or stroke by more than 80 percent.

Launched in 2015, EvidenceNOW is nearing its end, and it is exciting to celebrate improvements such as these. These successes were made possible through EvidenceNOW’s seven regional cooperatives, comprised of academic research centers and primary care quality improvement organizations that are providing participating practices customized support through practice facilitation. The assistance we’ve provided to more than 1,500 small- and medium-sized primary care practices in 12 states has supported better health for 8 million patients. You can learn more about these practices on the AHRQ Web site where there are stories about primary care practices today, the capacity of primary care practices to improve (PDF, 782 KB), and more stories of success.

Along with our partners in primary care, we’re excited about the potential of these efforts, as well as an independent national evaluation that continues through 2019 to examine the impact of different supports on practice improvement. Through the increased use of evidence in everyday care, we’re confident that we can address the national challenge of reducing heart disease.

This article was originally published on AHRQ Views Blog and is republished here with permission.