In this issue:
AHRQ Offers Heart Health Resources for You and Your Patients
In recognition of American Heart Month, AHRQ is highlighting its growing inventory of information tools and resources designed to help health care professionals compare evidence on treatments for heart and blood vessel conditions.
The Agency’s Effective Health Care (EHC) Program, in support of the growing use of evidence in shared decisionmaking between clinicians and patients, offers a library of heart health resources:
- Brief clinician research summaries that review the evidence on treatments for conditions such as hypertension, high cholesterol, and stable ischemic heart disease. Each provides the “Clinical Bottom Line” on the benefits and harms of treatments and rates the evidence behind research findings.
- Companion research summaries in English and Spanish for patients and caregivers. These plain-language publications complement the clinician research summaries and support shared decisionmaking.
- Free continuing education modules based on AHRQ research reviews. The modules are offered in various formats for physicians, nurses, nurse practitioners, pharmacists, physician assistants, case managers, and other professionals.
- Two dozen comprehensive research reviews on diagnosis and treatment strategies for heart and blood vessel conditions.
Every year, one of four deaths in the United States is due to heart disease. Cardiovascular disease, including heart disease and stroke, costs the United States $312.6 billion annually.1 AHRQ’s evidence-based information products are intended to improve the efficiency and quality of care for patients.
AHRQ has created a Treatment Options page (shown above) that can help patients “get the facts” about treatments for heart-related and other conditions and prepare for medical appointments.
- Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127(1):e6-e245.
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More Resources From the Effective Health Care Program
Bone Marrow Stem-Cell Transplants: Effective for Some Rare Pediatric Diseases
New materials from AHRQ's EHC Program evaluate the evidence of bone marrow transplants to effectively treat rare pediatric diseases. Findings suggest hematopoietic stem-cell transplantation can be an effective treatment for two rare fatal diseases: Wolman’s disease in infants and Farber’s disease Type 2/3. The clinician summary discusses the benefits and potential adverse effects of the intervention and provides an overview of the available evidence on this disease management approach. Resources include—
New Research Reviews Comparing Treatment Options
Treatment Approaches for Chronic Venous Ulcers
According to the latest research review from AHRQ, evidence is lacking on the benefits and harms of advanced wound dressings, systemic antibiotics, and surgical interventions for venous leg ulcers lasting six or more weeks in patients with preexisting venous disease. However, certain conclusions can be drawn from the available research. Antimicrobial dressings provide a healing advantage (moderate strength of evidence), but there is inconclusive evidence about the effectiveness of antimicrobial dressings versus each other or compression alone. Collagen dressings may improve the proportion of ulcers healed compared with compression (low strength of evidence), and allogenic bilayered human skin equivalents may promote more rapid healing (moderate strength of evidence), particularly among patients with long-standing venous leg ulcers, although this treatment did not affect post-treatment recurrence. Inconclusive evidence exists regarding the routine use of antibiotics and the effectiveness of advanced wound dressings on longer-term outcomes. When added to compression, superficial vein surgery (moderate strength of evidence) and haemodynamic correction procedure (CHIVA) (low strength of evidence) may lower the risk of ulcer recurrence, though neither improves healing. In contrast, subfascial endoscopic perforator vein surgery (SEPS) does not improve the healing rate or recurrence risk of chronic venous leg ulcers (high strength of evidence). Overall, insufficient evidence exists comparing the benefits and harms of surgical procedures for chronic venous leg ulcers. Additional research is needed. These findings are available in the research review Chronic Venous Ulcers: A Comparative Effectiveness Review of Treatment Modalities.
Meditation Programs: Effects on Stress Related Outcomes
According to AHRQ’s research review, meditation programs, in particular mindfulness programs designed to focus attention and awareness on inner and outer experiences with acceptance, patience and compassion, are beneficial for reducing psychological stress. These dimensions include anxiety, depression, and pain. However, there was insufficient evidence on the effect of meditation programs on positive mood, attention, substance use, eating, sleep, and weight. A national survey in 2008 found that the number of people meditating is increasing, with approximately 10 percent of the population having some experience with meditation. No evidence was found to suggest that meditation programs were superior to one specific therapy, such as exercise, yoga, progressive muscle relaxation, cognitive behavioral therapy, or medications. Stronger study designs are needed to determine the effects of meditation programs to improve the positive dimensions of mental health, as well as stress-related behavioral outcomes, such as positive mood, attention, substance use, eating, sleep, and weight. These findings can be found in the research review Meditation Programs for Psychological Stress and Well-being. Findings from the report were also published in the January 2014 edition of JAMA Internal Medicine.
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