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The American heart journal v.195, 2018년, pp.139 - 150   SCI SCIE
본 등재정보는 저널의 등재정보를 참고하여 보여주는 베타서비스로 정확한 논문의 등재여부는 등재기관에 확인하시기 바랍니다.

Design of a bilevel clinical trial targeting adherence in heart failure patients and their providers: The Congestive Heart Failure Adherence Redesign Trial (CHART)

Mangla, Ashvarya    (Department of Preventive Medicine, Rush University Medical Center, Chicago, IL   ); Doukky, Rami    (Department of Preventive Medicine, Rush University Medical Center, Chicago, IL   ); Richardson, DeJuran    (Department of Preventive Medicine, Rush University Medical Center, Chicago, IL   ); Avery, Elizabeth F.    (Department of Preventive Medicine, Rush University Medical Center, Chicago, IL   ); Dawar, Rebecca    (Department of Preventive Medicine, Rush University Medical Center, Chicago, IL   ); Calvin Jr., James E.    (Department of Medicine, Western University, London, ON, Canada   ); Powell Jr., Lynda H.    (Department of Preventive Medicine, Rush University Medical Center, Chicago, IL  );
  • 초록  

    Background Socioeconomically disadvantaged patients are at an increased risk for adverse heart failure (HF) outcomes based upon nonadherence to medications and diet. Physicians are also suboptimally adherent to prescribing evidence-based therapy for HF. Methods Congestive Heart Failure Adherence Redesign Trial (CHART) (NCT01698242) is a multicenter, bilevel, cluster randomized behavioral efficacy trial designed to assess the impact of intervening simultaneously on physicians and their socioeconomically disadvantaged patients (annual income Results A total of 72 physicians (treatment, 35; control, 37) and their 320 patients (treatment, 157; control, 163) were recruited within 2 years. Randomization of physicians with all of their patients being assigned to the same arm was feasible and did not compromise the comparability of patients by arm. Using 5 recruiting hospitals located within disadvantaged neighborhoods produced a cohort that was primarily African American and representative of low-income urban patients with HF with reduced ejection fraction. Conclusion CHART will determine the value of intervening on low adherence simultaneously in physicians and their socioeconomically disadvantaged patients in reducing all-cause hospitalization days.


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