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EHC Inside Track: Issue 2, March 2012

In this issue:

New Resources Encourage Broad Involvement in Research Process

A growing set of tools and resources from the Agency for Healthcare Research and Quality (AHRQ) is available to help researchers more effectively involve patients, caregivers, health care professionals, and others in their projects.

"Stakeholder involvement is critical for assuring that research questions are on target and that the results we obtain can be used to improve clinical practice and, ultimately, health outcomes," said Joanna Siegel, senior health research scientist at AHRQ’s Center for Outcomes and Evidence.

In addition to providing tools for researchers to broaden involvement in their projects, AHRQ also offers resources to increase involvement in its Effective Health Care (EHC) Program—resources aimed at making certain that EHC products are accessible, user-friendly, and responsive to people’s information needs.

Individuals or organizations can participate in EHC research projects in many ways, explained Siegel, from suggesting research topics, to acting as technical experts on current research, to advising on the best methods for communicating findings.

AHRQ’s new collection of resources includes materials on the following topics:

  • Exploring Innovations in Stakeholder Engagement – New approaches involve the community in health care research, including social media and grassroots organizing.
  • Engaging and Supporting Patient and Consumer Involvement in Research – Techniques and resources researchers can use to identify appropriate patient and consumer representatives to contribute to research and support their participation in the process.
  • Using Deliberative Methods – Intensive, participatory methods that help decisionmakers learn in depth about public values are well suited for obtaining public input related to complex health issues.
  • Becoming Involved in the Effective Health Care Program – Guidance for patients, consumers, clinicians, and others on how to suggest research topics and provide input on AHRQ’s current Effective Health Care Program research.

All of the tools are online at AHRQ’s Effective Health Care Program Web site.

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EHC Program Research Supports National Chronic Disease Reduction Efforts

The National Association of Chronic Disease Directors (NACDD) recently became one of more than 200 organizations partnering with AHRQ to help health professionals, patients, and caregivers make informed decisions about health care.

NACDD helps chronic disease directors and health professionals advocate for preventive policies and programs, share clinical information, and develop partnerships for health promotion. Member organizations specialize in disease and injury prevention, health promotion, and long-term care, as well as specific diseases and conditions such as diabetes, heart disease, and cancer.

NACDD and AHRQ will help chronic disease directors explore the value of patient-centered outcomes research and shared decisionmaking, empowering them to share resources from AHRQ’s Effective Health Care Program within their organizations and among colleagues.

"We feel it’s important to be part of this effort to provide health professionals and patients with unbiased, evidence-based resources they can work with," said NACDD chief executive officer John Robitscher, M.P.H. "We are in the position to mobilize public health professionals at every level to utilize these resources to reduce chronic disease and their associated risk factors."

Presentations at a recent NACDD board meeting and a meeting of more than 50 State-level public health leaders identified how patient-centered outcomes research can support chronic disease professionals. Working together, AHRQ and NACDD highlighted assembled resources for NACDD members and others interested in chronic diseases.

NACDD has also notified members about opportunities to comment on draft Effective Health Care Program research materials to help AHRQ ensure that research findings and related materials meet the needs of the populations they serve. Visit the Web site to explore items now open for comment.

If your organization wants to learn more about the Effective Health Care Program and the AHRQ national partnership network, visit www.effectivehealthcare.ahrq.gov or email us at EHC_Outreach@ahrq.hhs.gov.

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AHRQ Creates Facebook Page to Help Hispanics "Take the Reins" of their Health Care

Hispanic consumers at AHRQ exhibit booth during Toma las riendas launch

A new Spanish-language Facebook page is a cornerstone of AHRQ’s efforts to highlight the Effective Health Care Program’s growing array of Spanish-language publications.

The Facebook page, which features health information videos and links to publications that explore treatment options for conditions ranging from cancer to diabetes to depression, was launched as part of the AHRQ’s Toma las riendas ("Take the reins") campaign.

The campaign encouraged Hispanics to take control of their health care by exploring their treatment options. It was unveiled last fall at Telemundo’s Feria de la Familia in Washington, DC. The annual event—that brings a wide range of businesses, organizations, and entertainers to Hispanic consumers—attracted 25,000 attendees. Telemundo and other Hispanic-serving partner organizations joined AHRQ representatives on stage to sign a pledge promising to work together and encourage patients to become more active partners in their health care.

AHRQ will continue to build on Toma las riendas’ success by developing more partnerships with Hispanic-serving organizations. Current partners include the National Latina Health Network, the Latino Medical Student Association, the National Association for Hispanic Elderly, the National Center for Farmworker Health, the National Hispanic Council on Aging, and the National Hispanic Medical Association.

The Facebook page www.facebook.com/AHRQehc.espanolExit Disclaimer will remain a place for Spanish-speaking visitors to learn about AHRQ’s efforts to help them "take the reins" of their health. It includes an online version of the pledge for new and existing partners, and an archived version of a live Facebook chat with Toma las riendas campaign spokesperson Ileana M. Ponce- González, M.D., an AHRQ scientific review officer, who answered questions about how patients and health care professionals can use AHRQ’s Spanish-language resources.

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AMCP eDossier System Provides AHRQ Resources

The Academy of Managed Care Pharmacy (AMCP), an association of pharmacists and other health care practitioners who use the tools and techniques of managed care in pharmacy practice, provided comparative effectiveness research summaries and resources through the AMCP eDossier System.

The eDossier System is a Web-based platform that allows health care decisionmakers to easily access research to make informed, evidence-based decisions about health care, including formulary development and drug coverage decisions. It combines the familiar structure of paper-based dossiers with Web technologies that are flexible and interactive.

The eDossier system is available free to health care professionals and decisionmakers. Special electronic versions of AHRQ’s comparative effectiveness research reviews allow eDossier users to interact with the AHRQ reports by highlighting key excerpts or exporting charts, tables, and graphics into Microsoft PowerPoint or Word.

AMCP and AHRQ will continue to collaborate to ensure that relevant and recent data is available. For more information, visit www.amcp.edossiers.comExit Disclaimer.

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Funding Opportunity for Dissemination of Patient-Centered Outcomes Research

A new AHRQ Funding Opportunity Announcement seeks applications from health professional associations to develop innovative dissemination programs to integrate patient-centered outcomes research into clinical practice. Potential mechanisms could include education credentialing, scientific programs, or social media platforms. AHRQ anticipates funding between 25 to 50 awards totaling up to $2.5 million annually for 3 years. Applicants may receive no more than $100,000 annually in total costs for projects up to 3 years long. Applications are due April 25. To see the full funding opportunity announcement, go to http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-12-006.html

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Research Spotlight
Risks High For Elderly Patients Receiving Treatment to Fix Narrowed Heart Artery

Adverse events are common in patients 65 and older who undergo percutaneous coronary intervention (PCI), or angioplasty, to treat the narrowed unprotected left main coronary artery (ULMCA), according to new research from AHRQ’s Effective Health Care Program. The findings were highlighted in the February 14 issue of the Journal of the American College of Cardiology (JACC).

PCI treatment typically is reserved for patients at high risk for coronary artery bypass graft surgery or in high-urgency situations where survival outcomes are poor. Elderly patients currently represent 72.6 percent of patients who receive the PCI treatment for ULMCA stenosis. Poor health outcomes in elderly ULMCA patients are common, and likely influenced by both patient and procedural factors. The study showed 40 percent of elderly patients die within the first 3 years of followup after the procedure.

"In contemporary practice, patients selected to undergo ULMCA PCI are sick," explained Matthew Brennan, M.D., assistant professor of cardiology at Duke University Medical Center and lead investigator on the study. "However, this study suggests that patient comorbidities are not solely responsible for poor long-term outcomes in this cohort. Differences in technique may also influence long-term outcomes."

The study found that between 2004 and 2008, less than five percent of patients with ULMCA stenosis received PCI treatment. Trend data, however, indicate that the use of this procedure is slowly increasing, and it is being used more often for lower-urgency procedures. In light of this increase, it is important to examine the health risks and benefits for a broader population, said Dr. Brennan.

"A clinical trial among the high-risk patients who are currently undergoing PCI has much different clinical implications than a trial examining this treatment strategy in the larger group of lower risk patients with left main stenosis," said Dr. Brennan. "If the trial results are expected to inform future clinical practice, special efforts should be made to recruit lower risk patients."

Researchers concluded that clinical trials are needed to examine the safety and effectiveness of angioplasty in patients with ULMCA disease, as well as examining various stents used for this procedure. Particular attention should also be paid to best practices and including lower risk patients in the trials to increase the generalizability of trial populations.

An abstract of the JACC article Characteristics and Long-Term Outcomes of Percutaneous Revascularization of Unprotected Left Main Coronary Artery Stenosis in the United States is available on PubMed. More research findings and information about the Effective Health Care Program can be found at www.effectivehealthcare.ahrq.gov.

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New Effective Health Care Program Resources

To access all Effective Health Care Program Resources, visit www.effectivehealthcare.ahrq.gov.

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About the EHC Inside Track

EHC Inside Track is a newsletter highlighting important news and developments from AHRQ’s Effective Health Care Program.

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