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Nancy Marie Allen LaPointe

Adjunct Associate Professor in the Department of Medicine
Medicine, Cardiology
Remote, Raleigh, NC 27607
Remote, Raleigh, NC 27607

Selected Publications


Facilitating Shared Decision Making Among Black Patients at Risk for Sudden Cardiac Arrest : A Randomized Clinical Trial.

Journal Article Ann Intern Med · May 2023 BACKGROUND: Racial disparities in implantable cardioverter-defibrillator (ICD) implantation are multifactorial and are partly explained by higher refusal rates. OBJECTIVE: To assess the effectiveness of a video decision support tool for Black patients elig ... Full text Link to item Cite

Cardiac resynchronization therapy outcomes with left ventricular lead concordant with latest mechanical activation: A meta-analysis.

Journal Article Pacing Clin Electrophysiol · August 2022 BACKGROUND: For cardiac resynchronization therapy (CRT), image-guided approaches targeting left ventricular (LV) lead placement at the site of latest mechanical activation had inconsistent outcomes. We examined evidence for improved CRT outcomes when LV le ... Full text Link to item Cite

Outcomes of Cardiac Resynchronization Therapy with Image-Guided Left Ventricular Lead Placement at the Site of Latest Mechanical Activation: A Systematic Review and Meta-Analysis.

Journal Article J Interv Cardiol · 2022 AIM: To assess evidence for an image-guided approach for cardiac resynchronization therapy (CRT) that targets left ventricular (LV) lead placement at the segment of latest mechanical activation. METHODS: A systematic review of EMBASE and PubMed was perform ... Full text Open Access Link to item Cite

Impact of Contrast Echocardiography on Outcomes in Critically Ill Patients.

Journal Article Am J Cardiol · July 1, 2021 Limited data suggests ultrasound enhancing agent (UEA) use is associated with changes in clinical management and lower mortality in intensive care unit (ICU) patients. We conducted a retrospective observational study to determine if contrast echocardiograp ... Full text Link to item Cite

Right ventricular lead location and outcomes among patients with cardiac resynchronization therapy: A meta-analysis.

Journal Article Prog Cardiovasc Dis · 2021 BACKGROUND: Cardiac resynchronization therapy (CRT) has been demonstrated to improve heart failure (HF) symptoms, reverse LV remodeling, and reduce mortality and HF hospitalization (HFH) in patients with a reduced left ventricular (LV) ejection fraction (L ... Full text Link to item Cite

Long-Term Outcomes and Associations With Major Adverse Limb Events After Peripheral Artery Revascularization.

Journal Article J Am Coll Cardiol · February 11, 2020 BACKGROUND: Long-term cardiovascular and limb outcomes after revascularization for peripheral artery disease and, in particular, prognosis after post-procedure major adverse limb events (MALE) are not well-studied. OBJECTIVES: This study sought to describe ... Full text Link to item Cite

Videos to reduce racial disparities in ICD therapy Via Innovative Designs (VIVID) trial: Rational, design and methodology.

Journal Article Am Heart J · February 2020 BACKGROUND: Despite a higher prevalence of sudden cardiac death (SCD), black individuals are less likely than whites to have an implantable cardioverter defibrillator (ICD) implanted. Racial differences in ICD utilization is in part explained by higher ref ... Full text Link to item Cite

Interventions for Preventing Thromboembolic Events in Patients With Atrial Fibrillation: A Systematic Review.

Journal Article Ann Intern Med · December 4, 2018 BACKGROUND: The comparative safety and effectiveness of treatments to prevent thromboembolic complications in atrial fibrillation (AF) remain uncertain. PURPOSE: To compare the effectiveness of medical and procedural therapies in preventing thromboembolic ... Full text Link to item Cite

Predicting Thromboembolic and Bleeding Event Risk in Patients with Non-Valvular Atrial Fibrillation: A Systematic Review.

Journal Article Thromb Haemost · December 2018 BACKGROUND:  Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of stroke. Medical therapy for decreasing stroke risk involves anticoagulation, which may increase bleeding risk for certain patients. In determining the optimal t ... Full text Link to item Cite

Major Adverse Limb Events and 1-Year Outcomes After Peripheral Artery Revascularization.

Journal Article J Am Coll Cardiol · August 28, 2018 BACKGROUND: Revascularization is important for symptom treatment and limb salvage in peripheral artery disease, yet little data exist on the incidence of post-procedure major adverse limb events (MALE) and longer-term outcomes. OBJECTIVES: This study sough ... Full text Link to item Cite

Nonpharmacologic Treatments for Attention-Deficit/Hyperactivity Disorder: A Systematic Review.

Journal Article Pediatrics · June 2018 CONTEXT: Nonpharmacologic treatments for attention-deficit/hyperactivity disorder (ADHD) encompass a range of care approaches from structured behavioral interventions to complementary medicines. OBJECTIVES: To assess the comparative effectiveness of nonpha ... Full text Link to item Cite

Dofetilide dose reductions and discontinuations in women compared with men.

Journal Article Heart Rhythm · April 2018 BACKGROUND: Compared with men, women have longer corrected QT (QTc) intervals, lower clearance of dofetilide, and higher rates of drug-induced torsades de pointes, but the dofetilide dosing algorithm is the same for men and women. OBJECTIVE: The purpose of ... Full text Link to item Cite

Facilitating Shared Decision Making Among Black Patients at Risk for Sudden Cardiac Arrest : A Randomized Clinical Trial.

Journal Article Ann Intern Med · May 2023 BACKGROUND: Racial disparities in implantable cardioverter-defibrillator (ICD) implantation are multifactorial and are partly explained by higher refusal rates. OBJECTIVE: To assess the effectiveness of a video decision support tool for Black patients elig ... Full text Link to item Cite

Cardiac resynchronization therapy outcomes with left ventricular lead concordant with latest mechanical activation: A meta-analysis.

Journal Article Pacing Clin Electrophysiol · August 2022 BACKGROUND: For cardiac resynchronization therapy (CRT), image-guided approaches targeting left ventricular (LV) lead placement at the site of latest mechanical activation had inconsistent outcomes. We examined evidence for improved CRT outcomes when LV le ... Full text Link to item Cite

Outcomes of Cardiac Resynchronization Therapy with Image-Guided Left Ventricular Lead Placement at the Site of Latest Mechanical Activation: A Systematic Review and Meta-Analysis.

Journal Article J Interv Cardiol · 2022 AIM: To assess evidence for an image-guided approach for cardiac resynchronization therapy (CRT) that targets left ventricular (LV) lead placement at the segment of latest mechanical activation. METHODS: A systematic review of EMBASE and PubMed was perform ... Full text Open Access Link to item Cite

Impact of Contrast Echocardiography on Outcomes in Critically Ill Patients.

Journal Article Am J Cardiol · July 1, 2021 Limited data suggests ultrasound enhancing agent (UEA) use is associated with changes in clinical management and lower mortality in intensive care unit (ICU) patients. We conducted a retrospective observational study to determine if contrast echocardiograp ... Full text Link to item Cite

Right ventricular lead location and outcomes among patients with cardiac resynchronization therapy: A meta-analysis.

Journal Article Prog Cardiovasc Dis · 2021 BACKGROUND: Cardiac resynchronization therapy (CRT) has been demonstrated to improve heart failure (HF) symptoms, reverse LV remodeling, and reduce mortality and HF hospitalization (HFH) in patients with a reduced left ventricular (LV) ejection fraction (L ... Full text Link to item Cite

Long-Term Outcomes and Associations With Major Adverse Limb Events After Peripheral Artery Revascularization.

Journal Article J Am Coll Cardiol · February 11, 2020 BACKGROUND: Long-term cardiovascular and limb outcomes after revascularization for peripheral artery disease and, in particular, prognosis after post-procedure major adverse limb events (MALE) are not well-studied. OBJECTIVES: This study sought to describe ... Full text Link to item Cite

Videos to reduce racial disparities in ICD therapy Via Innovative Designs (VIVID) trial: Rational, design and methodology.

Journal Article Am Heart J · February 2020 BACKGROUND: Despite a higher prevalence of sudden cardiac death (SCD), black individuals are less likely than whites to have an implantable cardioverter defibrillator (ICD) implanted. Racial differences in ICD utilization is in part explained by higher ref ... Full text Link to item Cite

Interventions for Preventing Thromboembolic Events in Patients With Atrial Fibrillation: A Systematic Review.

Journal Article Ann Intern Med · December 4, 2018 BACKGROUND: The comparative safety and effectiveness of treatments to prevent thromboembolic complications in atrial fibrillation (AF) remain uncertain. PURPOSE: To compare the effectiveness of medical and procedural therapies in preventing thromboembolic ... Full text Link to item Cite

Predicting Thromboembolic and Bleeding Event Risk in Patients with Non-Valvular Atrial Fibrillation: A Systematic Review.

Journal Article Thromb Haemost · December 2018 BACKGROUND:  Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of stroke. Medical therapy for decreasing stroke risk involves anticoagulation, which may increase bleeding risk for certain patients. In determining the optimal t ... Full text Link to item Cite

Major Adverse Limb Events and 1-Year Outcomes After Peripheral Artery Revascularization.

Journal Article J Am Coll Cardiol · August 28, 2018 BACKGROUND: Revascularization is important for symptom treatment and limb salvage in peripheral artery disease, yet little data exist on the incidence of post-procedure major adverse limb events (MALE) and longer-term outcomes. OBJECTIVES: This study sough ... Full text Link to item Cite

Nonpharmacologic Treatments for Attention-Deficit/Hyperactivity Disorder: A Systematic Review.

Journal Article Pediatrics · June 2018 CONTEXT: Nonpharmacologic treatments for attention-deficit/hyperactivity disorder (ADHD) encompass a range of care approaches from structured behavioral interventions to complementary medicines. OBJECTIVES: To assess the comparative effectiveness of nonpha ... Full text Link to item Cite

Dofetilide dose reductions and discontinuations in women compared with men.

Journal Article Heart Rhythm · April 2018 BACKGROUND: Compared with men, women have longer corrected QT (QTc) intervals, lower clearance of dofetilide, and higher rates of drug-induced torsades de pointes, but the dofetilide dosing algorithm is the same for men and women. OBJECTIVE: The purpose of ... Full text Link to item Cite

Outcomes of a multi-community hypertension implementation study: the American Heart Association's Check. Change. Control. program.

Journal Article J Clin Hypertens (Greenwich) · May 2017 UNLABELLED: Single-site, intensive, community-based blood pressure (BP) intervention programs have led to BP improvements. The authors examined the American Heart Association's Check. Change. CONTROL: (CCC) program (4069 patients/18 cities) to determine wh ... Full text Link to item Cite

Use of Antiarrhythmic Medications in Medicare Part D Patients With an Implantable Cardioverter-Defibrillator and Ventricular Tachycardia.

Journal Article Am J Cardiol · May 1, 2017 Ventricular tachycardia (VT) is common in cardiomyopathy patients with an implantable cardioverter-defibrillator. This analysis evaluated antiarrhythmic medication use and change in use over time in patients with VT and structural heart disease. Query of M ... Full text Link to item Cite

Primary care providers' use of pharmacist support for delivery of pharmacogenetic testing.

Journal Article Pharmacogenomics · March 2017 AIM: To investigate provider utilization of pharmacist support in the delivery of pharmacogenetic testing in a primary care setting. METHODS: Two primary care clinics within Duke University Health System participated in the study between December 2012 and ... Full text Link to item Cite

Patient experiences with pharmacogenetic testing in a primary care setting.

Journal Article Pharmacogenomics · October 2016 AIM: To investigate patient experiences with pharmacogenetic (PGx) testing. METHODS: Patients were offered PGx testing through a study on pharmacist-assisted delivery of PGx testing and invited to complete pre- and post-testing surveys about their experien ... Full text Link to item Cite

Reporting of Sex Effects by Systematic Reviews on Interventions for Depression, Diabetes, and Chronic Pain.

Journal Article Ann Intern Med · August 2, 2016 Systematic reviews (SRs) have the potential to contribute uniquely to the evaluation of sex and gender differences (termed "sex effects"). This article describes the reporting of sex effects by SRs on interventions for depression, type 2 diabetes mellitus, ... Full text Link to item Cite

Incorporation of pharmacogenetic testing into medication therapy management.

Journal Article Pharmacogenomics · November 2015 AIM: To assess feasibility and patient satisfaction with a pharmacist-delivered medication therapy management (MTM) plus pharmacogenetic (PGx) testing service. METHODS: Thirty patients from a cardiology outpatient clinic were enrolled to attend two MTM ses ... Full text Link to item Cite

Comparisons of hospitalization rates among younger atrial fibrillation patients receiving different antiarrhythmic drugs.

Journal Article Circ Cardiovasc Qual Outcomes · May 2015 Featured Publication BACKGROUND: Antiarrhythmic drugs (AADs) are used to reduce the frequency, severity, and duration of atrial fibrillation (AF) events, which should reduce hospitalizations; however, little is known about the associations between different AADs and hospitaliz ... Full text Link to item Cite

Challenges to integrating pharmacogenetic testing into medication therapy management.

Journal Article J Manag Care Spec Pharm · April 2015 Some have proposed the integration of pharmacogenetic (PGx) testing into medication therapy management (MTM) to enable further refinement of treatments to reduce risk of adverse responses and improve efficacy. PGx testing involves the analysis of genetic v ... Full text Link to item Cite

RECONSIDERING APPROPRIATE DOFETILIDE DOSING IN WOMEN

Conference Journal of the American College of Cardiology · March 2015 Full text Cite

Antiarrhythmic drug use in patients <65 years with atrial fibrillation and without structural heart disease.

Journal Article Am J Cardiol · February 1, 2015 Featured Publication Little is known in clinical practice about antiarrhythmic drug (AAD) use in patients with atrial fibrillation (AF) (particularly younger ones) who do not have structural heart disease. Using the MarketScan database, we identified patients <65 years without ... Full text Link to item Cite

Patient-centered interventions to improve medication management and adherence: a qualitative review of research findings.

Journal Article Patient Educ Couns · December 2014 OBJECTIVE: Patient-centered approaches to improving medication adherence hold promise, but evidence of their effectiveness is unclear. This review reports the current state of scientific research around interventions to improve medication management throug ... Full text Link to item Cite

Check it, change it: a community-based, multifaceted intervention to improve blood pressure control.

Journal Article Circ Cardiovasc Qual Outcomes · November 2014 BACKGROUND: Although home blood pressure (BP) monitoring interventions have shown potential in selected populations, it is unclear whether such strategies can be generalized. We sought to determine whether a multifaceted BP control program that uses a web- ... Full text Link to item Cite

Pilot study: incorporation of pharmacogenetic testing in medication therapy management services.

Journal Article Pharmacogenomics · November 2014 Aim: To describe the rationale and design of a pilot study evaluating the integration of pharmacogenetic (PGx) testing into pharmacist-delivered medication therapy management (MTM). Study rationale: Clinical delivery approaches of PGx testing involving pha ... Full text Link to item Cite

Comparison of safety of sotalol versus amiodarone in patients with atrial fibrillation and coronary artery disease.

Journal Article Am J Cardiol · September 1, 2014 Sotalol is a commonly prescribed antiarrhythmic drug (AAD) used for maintaining sinus rhythm in patients with atrial fibrillation (AF). Although randomized studies have found that sotalol can significantly delay time to AF recurrence, its association with ... Full text Link to item Cite

Pilot study of pharmacist-assisted delivery of pharmacogenetic testing in a primary care setting.

Journal Article Pharmacogenomics · September 2014 AIM: To describe the rationale and design of a pilot program to implement and evaluate pharmacogenetic (PGx) testing in a primary care setting. STUDY RATIONALE: Several factors have impeded the uptake of PGx testing, including lack of provider knowledge an ... Full text Link to item Cite

Rate- and rhythm-control therapies in patients with atrial fibrillation: a systematic review.

Journal Article Ann Intern Med · June 3, 2014 Featured Publication BACKGROUND: The comparative effectiveness of treatments for atrial fibrillation (AF) is uncertain. PURPOSE: To evaluate the comparative effectiveness of rate- and rhythm-control therapies. DATA SOURCES: English-language studies in PubMed, EMBASE, and the C ... Full text Link to item Cite

Use Of Rate And Rhythm Control Drugs In Patients Younger Than 65 Years With Atrial Fibrillation.

Journal Article J Atr Fibrillation · 2014 Little is known about the use of pharmacologic rhythm or rate control in younger atrial fibrillation (AF) patients in clinical practice. Using commercial health data from 2006 through 2010, patients aged <65 years with an initial AF encounter were categori ... Link to item Cite

The potential impact of pharmacogenetic testing on medication adherence.

Journal Article Pharmacogenomics J · December 2013 Poor medication adherence is a well-known problem, particularly in patients with chronic conditions, and is associated with significant morbidity, mortality and health-care costs. Multi-faceted and personalized interventions have shown the greatest success ... Full text Link to item Cite

Adherence to guideline recommendations for antiarrhythmic drugs in atrial fibrillation.

Journal Article Am Heart J · November 2013 BACKGROUND: Atrial fibrillation (AF) guideline recommendations for antiarrhythmic drugs (AADs) are based on the effectiveness and safety of the AAD in patients with selected, concomitant heart disease. It is unknown to what extent these recommendations are ... Full text Link to item Cite

Check it, change it: a community-based intervention to improve blood pressure control.

Journal Article Circ Cardiovasc Qual Outcomes · November 2013 BACKGROUND: Despite the widespread availability of effective and affordable therapies, hypertension remains this country's most significant modifiable cardiovascular risk factor. Approximately 30% to 50% of individuals with hypertension currently fail to r ... Full text Link to item Cite

Educational videos to reduce racial disparities in ICD therapy via innovative designs (VIVID): a randomized clinical trial.

Journal Article Am Heart J · July 2013 BACKGROUND: Black individuals eligible for an implantable cardioverter/defibrillator (ICD) are considerably less likely than white individuals to receive one. This disparity may, in part, be explained by racial differences in patient preferences. We hypoth ... Full text Link to item Cite

Decision support for evidence-based pharmacotherapy detects adherence problems but does not impact medication use.

Journal Article Stud Health Technol Inform · 2013 Although evidence-based pharmacotherapies are a principal component of patient care, 30-50% of patients do not take their medications as prescribed. We conducted a randomized trial of two clinical decision support (CDS) interventions in 2219 patients: pati ... Link to item Cite

Check It Change It: A Community Based Hypertension Program

Journal Article CIRCULATION · November 20, 2012 Link to item Cite

Is heart failure guideline adherence being underestimated? The impact of therapeutic contraindications.

Journal Article Am Heart J · November 2012 BACKGROUND: Several studies based on claims data have reported underutilization of evidence-based heart failure (HF) therapies. The degree to which these estimates fail to account for therapeutic contraindications is unclear. METHODS: We identified patient ... Full text Link to item Cite

Improving care transitions: current practice and future opportunities for pharmacists.

Journal Article Pharmacotherapy · November 2012 During the past decade, patient safety issues during care transitions have gained greater attention at both the local and national level. Readmission rates to U.S. hospitals are high, often because of poor care transitions. Serious adverse drug events (ADE ... Full text Link to item Cite

Patient-focused intervention to improve long-term adherence to evidence-based medications: a randomized trial.

Journal Article Am Heart J · April 2012 Featured Publication BACKGROUND: Nonadherence to cardiovascular medications is a significant public health problem. This randomized study evaluated the effect on medication adherence of linking hospital and community pharmacists. METHODS: Hospitalized patients with coronary ar ... Full text Link to item Cite

Association between patient beliefs and medication adherence following hospitalization for acute coronary syndrome.

Journal Article Am Heart J · May 2011 Featured Publication BACKGROUND: Patient adherence to medications is crucial for reducing risks following acute coronary syndrome (ACS). We assessed the degree to which medication beliefs were associated with patient adherence to β-blockers, angiotensin-converting enzyme inhib ... Full text Link to item Cite

Extent of and reasons for nonuse of implantable cardioverter defibrillator devices in clinical practice among eligible patients with left ventricular systolic dysfunction.

Journal Article Circ Cardiovasc Qual Outcomes · March 2011 Featured Publication BACKGROUND: Several studies that used claims and registry data have reported that 40% to 80% of patients eligible for an implantable cardioverter defibrillator (ICD) fail to receive one in clinical practice, and the rates are especially high among women an ... Full text Link to item Cite

Improving Medication Adherence in a Regional Healthcare Information Exchange using a Scalable, Claims-Driven, and Service-Oriented Approach.

Journal Article AMIA Annu Symp Proc · November 13, 2010 Featured Publication Evidence-based pharmacotherapy is a central aspect of optimal patient care for many chronic conditions. However, medication non-adherence frequently inhibits the attainment of optimal pharmacotherapy regimens. In this study, we designed, developed, and imp ... Link to item Cite

Changes in beliefs about medications during long-term care for ischemic heart disease.

Journal Article Am Heart J · April 2010 Featured Publication BACKGROUND: Beliefs such as self-reported low necessity for medications and high concerns about medications are associated with nonadherence. Changes in these beliefs during long-term care have not previously been studied and were evaluated for purposes of ... Full text Link to item Cite

In-hospital management of patients with atrial flutter.

Journal Article Am Heart J · March 2010 Featured Publication BACKGROUND: Little is known about the use of drugs or procedures for management of atrial flutter (AFl) in routine clinical practice. We describe the extent of use of conversion therapies during AFl hospitalizations. METHODS: We examined hospitalizations f ... Full text Link to item Cite

Relation of patient age and mortality to reported contraindications to early beta-blocker use for non-ST-elevation acute coronary syndrome.

Journal Article Am J Cardiol · November 15, 2009 Featured Publication We evaluated the reported contraindications to early beta-blocker use and associated mortality within and across patient age groups. Contraindications to early beta-blocker use were evaluated in patients with non-ST-elevation acute coronary syndrome in the ... Full text Link to item Cite

Predictors of early discontinuation of evidence-based medicine after acute coronary syndrome.

Journal Article Am J Cardiol · July 15, 2009 Use of evidence-based medicine (EBM) improves outcomes after acute coronary syndromes (ACS), yet patients often discontinue prescribed therapies after discharge. Although such discontinuation is well documented, patients' reasons for medication discontinua ... Full text Link to item Cite

Use of beta-blockers in patients with an implantable cardioverter defibrillator.

Journal Article Ann Pharmacother · July 2009 Featured Publication BACKGROUND: Implantable cardioverter defibrillators (ICDs) are indicated for both primary and secondary prevention of sudden cardiac arrest. beta-Blockers are also indicated in most patients who have an indication for an ICD; however, their use in this pop ... Full text Link to item Cite

Association between mortality and persistent use of beta blockers and angiotensin-converting enzyme inhibitors in patients with left ventricular systolic dysfunction and coronary artery disease.

Journal Article Am J Cardiol · June 1, 2009 Featured Publication Beta blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) are evidence-based medications for chronic heart failure, but little is known about the persistent use and clinical effectiveness of these medications. We ... Full text Link to item Cite

Unfractionated heparin dosing and risk of major bleeding in non-ST-segment elevation acute coronary syndromes.

Journal Article Am Heart J · August 2008 BACKGROUND: Unfractionated heparin (UFH) is a mainstay of treatment for patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS), but the practice of weight-adjusted bolus and infusion dosing has not been carefully evaluated. METHODS: Usi ... Full text Link to item Cite

Transfusion practice and outcomes in non-ST-segment elevation acute coronary syndromes.

Journal Article Am Heart J · June 2008 OBJECTIVES: To describe the association between transfusion and outcomes as a function of nadir hematocrit (HCT) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS). BACKGROUND: The adverse outcomes associated with transfusion in ... Full text Link to item Cite

Rhythm versus rate control in the contemporary management of atrial fibrillation in-hospital.

Journal Article Am J Cardiol · April 15, 2008 Featured Publication Little is presently known regarding whether a rhythm-control or a rate-control strategy is more frequently used in patients hospitalized for atrial fibrillation (AF). This study was conducted to assess patient and physician characteristics associated with ... Full text Link to item Cite

Outpatient use of anticoagulants, rate-controlling drugs, and antiarrhythmic drugs for atrial fibrillation.

Journal Article Am Heart J · November 2007 Featured Publication BACKGROUND: The first clinical practice guidelines for management of atrial fibrillation (AF) were published in 2001. We explored the use of anticoagulants, rate-controlling drugs, and antiarrhythmic drugs in patients with AF during the 4 years surrounding ... Full text Link to item Cite

Development and evaluation of an improved methodology for assessing adherence to evidence-based drug therapy guidelines using claims data.

Journal Article AMIA Annu Symp Proc · October 11, 2007 Non-adherence to evidence-based pharmacotherapy is associated with increased morbidity and mortality. Claims data can be used to detect and intervene on such non-adherence, but existing claims-based approaches for measuring adherence to pharmacotherapy gui ... Link to item Cite

Enoxaparin dosing and associated risk of in-hospital bleeding and death in patients with non ST-segment elevation acute coronary syndromes.

Journal Article Arch Intern Med · July 23, 2007 Featured Publication BACKGROUND: The efficacy of enoxaparin sodium in non-ST-segment elevation acute coronary syndromes is well established; however, concerns remain regarding bleeding risk. The extent to which bleeding risk is attributable to excess dosing of enoxaparin is un ... Full text Link to item Cite

Patient receipt and understanding of written information provided with isotretinoin and estrogen prescriptions.

Journal Article J Gen Intern Med · January 2007 Featured Publication BACKGROUND: Medication guides (MG) and mandatory patient package inserts (MPPI) are required with some prescription medications. OBJECTIVE: We sought to determine how many patients receive, read, and understand these mandated materials. DESIGN AND PARTICIP ... Full text Link to item Cite

National evaluation of adherence to beta-blocker therapy for 1 year after acute myocardial infarction in patients with commercial health insurance.

Journal Article Am Heart J · September 2006 BACKGROUND: Quality measures of evidence-based medications post-myocardial infarction have focused on prescription at hospital discharge. Yet survival benefits of these medications are best realized with sustained therapy. We sought to examine long-term be ... Full text Link to item Cite

Frequency of high-risk use of QT-prolonging medications.

Journal Article Pharmacoepidemiol Drug Saf · June 2006 Featured Publication PURPOSE: Prolongation of the QT interval has been associated with increased risk of torsades de pointes and death. Concurrent use of more than one QT-prolonging drug or a QT-prolonging drug with a drug that alters its pharmacokinetic profile is an importan ... Full text Link to item Cite

Multifaceted intervention to promote beta-blocker use in heart failure.

Journal Article Am Heart J · May 2006 Featured Publication BACKGROUND: Despite a survival benefit and guideline recommendation for beta-blockers in left ventricular systolic dysfunction, beta-blockers are underused in clinical practice. METHODS: Medical practices with > or = 15 patients with heart failure (HF) in ... Full text Link to item Cite

How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure. Results from the Breathing Not Properly Multinational Study.

Journal Article Am Heart J · May 2006 BACKGROUND: B-type natriuretic peptide (BNP) is valuable in diagnosing heart failure (HF), but its utility in obese patients is unknown. Studies have suggested a cut-point of BNP > or = 100 pg/mL for the diagnosis of HF; however, there is an inverse relati ... Full text Link to item Cite

Long-term adherence to evidence-based secondary prevention therapies in coronary artery disease.

Journal Article Circulation · January 17, 2006 Featured Publication BACKGROUND: Studies have examined the use of evidence-based therapies for coronary artery disease (CAD) in the short term and at hospital discharge, but few have evaluated long-term use. METHODS AND RESULTS: Using the Duke Databank for Cardiovascular Disea ... Full text Link to item Cite

Authors' reply

Journal Article American Heart Journal · 2006 Full text Cite

Excess dosing of antiplatelet and antithrombin agents in the treatment of non-ST-segment elevation acute coronary syndromes.

Journal Article JAMA · December 28, 2005 CONTEXT: Effective medical care assumes delivery of evidence-based medicines to appropriate patients with doses comparable to those studied. OBJECTIVE: To investigate dosing of unfractionated heparin (UFH), low-molecular-weight heparin (LMWH), and glycopro ... Full text Link to item Cite

A survey of health care practitioners' knowledge of the QT interval.

Journal Article J Gen Intern Med · May 2005 Featured Publication OBJECTIVE: To assess health care practitioners' ability to correctly measure the QT interval, and to identify factors and medications that may increase the risk of QT-interval prolongation and torsades de pointes. DESIGN: A cross-sectional analysis of a su ... Full text Link to item Cite

1096-71 A national survey of health care practitioners' knowledge of the QT interval

Conference Journal of the American College of Cardiology · March 2004 Full text Cite

Economic effects of beta-blocker therapy in patients with heart failure.

Journal Article Am J Med · January 15, 2004 PURPOSE: Studies suggest that beta-blockers improve outcomes in heart failure patients and may be cost saving to society. However, many heart failure patients are not treated with beta-blockers. Economic incentives facing hospitals, physicians, payers, and ... Full text Link to item Cite

Aspirin use post-acute coronary syndromes: intolerance, bleeding and discontinuation.

Journal Article J Thromb Thrombolysis · December 2003 BACKGROUND: While aspirin's secondary prevention benefit is clear, prior reports indicate that 19-83% of eligible patients may not use aspirin chronically. METHODS: We investigated intolerance and bleeding while on aspirin and aspirin discontinuation using ... Full text Link to item Cite

Evaluation of the dofetilide risk-management program.

Journal Article Am Heart J · November 2003 Featured Publication BACKGROUND: Dose-dependent torsades de pointes has been shown to occur with dofetilide (Tikosyn) and sotalol HCl (Betapace AF); thus, detailed dosing and monitoring recommendations to minimize this risk are included in the product labeling for both drugs. ... Full text Link to item Cite

New antiarrhythmic agents for atrial fibrillation and atrial flutter: United States drug market response as an indicator of acceptance.

Journal Article Pharmacotherapy · October 2003 Featured Publication OBJECTIVE: To determine how well dofetilide and Betapace AF (sotalol, approved solely for atrial fibrillation and atrial flutter), with their detailed dosing and monitoring guidelines for safety, were accepted into clinical practice during the 2 calendar y ... Full text Link to item Cite

Medication errors in hospitalized cardiovascular patients.

Journal Article Arch Intern Med · June 23, 2003 Featured Publication BACKGROUND: The Institute of Medicine's report To Err Is Human: Building a Safer Health System recommends pharmacist participation in patient rounds as an immediate approach to reducing medical errors. In the same report and in prior publications, cardiova ... Full text Link to item Cite

What clinicians should know about the QT interval.

Journal Article JAMA · April 23, 2003 Featured Publication CONTEXT: Of the several factors implicated in causing QT interval prolongation and torsades de pointes, errors in the use of medications that may prolong this interval deserve special attention. OBJECTIVE: To systematically summarize the available clinical ... Full text Link to item Cite

Knowledge deficits related to the QT interval could affect patient safety.

Journal Article Ann Noninvasive Electrocardiol · April 2003 Featured Publication BACKGROUND: Recently, some QT-prolonging, noncardiac medications were withdrawn from the U.S. drug market because of continued inappropriate use by health care practitioners despite warnings and label changes from both the drug manufacturers and the U.S. F ... Full text Link to item Cite

Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients.

Journal Article Am J Med · February 1, 2003 Many drugs prolong the QT interval and increase the risk of torsade de pointes. Concurrent use of two or more of these drugs can further increase the risk, but the prevalence of concurrent prescription of QT-prolonging drugs is not known. Using the adminis ... Full text Link to item Cite

Outpatient prescribing of antiarrhythmic drugs from 1995 to 2000.

Journal Article Am J Cardiol · January 1, 2003 Featured Publication Full text Link to item Cite

Practitioner acceptance of the dofetilide risk-management program.

Journal Article Pharmacotherapy · August 2002 Featured Publication STUDY OBJECTIVE: To assess the opinions and knowledge retention of practitioners after participation in the dofetilide risk-management program. DESIGN: A 21-item questionnaire. SETTING: A large academic medical center. PARTICIPANTS: One hundred forty-six p ... Full text Link to item Cite

Patient-reported frequency of taking aspirin in a population with coronary artery disease.

Journal Article Am J Cardiol · May 1, 2002 Despite the established benefits of antiplatelet agents in coronary artery disease (CAD), many appropriate patients are not receiving them. We investigated the prevalence of and factors associated with aspirin use and nonuse within a large referral populat ... Full text Link to item Cite

Underuse of aspirin in a referral population with documented coronary artery disease.

Journal Article Am J Cardiol · March 15, 2002 Despite substantial evidence that antiplatelet therapy saves lives and reduces adverse events in patients with coronary artery disease (CAD), use of the most widely available and lowest cost antiplatelet agent, aspirin, continues to be disappointingly low. ... Full text Link to item Cite

Continuous intravenous quinidine infusion for the treatment of atrial fibrillation or flutter: a case series.

Journal Article Am Heart J · January 2000 BACKGROUND: The purpose of the study was to evaluate a continuous intravenous quinidine infusion (CIQI) for the treatment of cardiac arrhythmias in critically ill patients. METHODS AND RESULTS: A 2-year retrospective review was conducted in adult patients ... Full text Link to item Cite

Digoxin toxicity: an evaluation in current clinical practice.

Journal Article Arch Intern Med · December 7, 1998 BACKGROUND: Serum digoxin concentrations (SDCs) are frequently sampled before completion of drug distribution. If elevated, these concentrations may be misinterpreted, potentially leading to a misdiagnosis of digoxin toxicity. OBJECTIVES: To determine the ... Full text Link to item Cite

Procainamide administration during pregnancy.

Journal Article Clin Pharm · January 1993 Link to item Cite

Relationship between serum quinidine concentration and quinidine dosage.

Journal Article Pharmacotherapy · 1992 This retrospective study was designed to identify and assess which patient-specific factors affect the relationship between the steady-state trough serum quinidine concentration (SQC) measured by fluorescence polarization immunoassay and quinidine dosage. ... Link to item Cite

Clinical and pharmacokinetic profiles of digoxin immune Fab in four patients with renal impairment.

Journal Article DICP · December 1991 Minimal pharmacokinetic data on digoxin immune Fab are currently available, especially in patients with impaired renal function. The serum concentration-time profiles of total digoxin, free digoxin, and digoxin immune Fab in four patients with moderate to ... Full text Link to item Cite

Retreatment with digoxin immune Fab.

Journal Article Clin Pharm · November 1991 Link to item Cite

Treatment of digitalis intoxication with emphasis on the clinical use of digoxin immune Fab.

Journal Article DICP · October 1990 Many studies and cases of digitalis intoxication have been reported since the time of William Withering's first publication in 1785. Recognition and management of digitalis toxicity is challenging. Before digoxin immune Fab was commercially available, trea ... Full text Link to item Cite