Last data update: Jun 03, 2024. (Total: 46935 publications since 2009)
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Query Trace: Jones CD [original query] |
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Pharmacist Interventions for Medication Adherence: Community Guide Economic Reviews for Cardiovascular Disease
Jacob V , Reynolds JA , Chattopadhyay SK , Hopkins DP , Therrien NL , Jones CD , Durthaler JM , Rask KJ , Cuellar AE , Clymer JM , Kottke TE . Am J Prev Med 2021 62 (3) e202-e222 INTRODUCTION: Adherence to medications for cardiovascular disease and its risk factors is less than optimal, although greater adherence to medication has been shown to reduce the risk factors for cardiovascular disease. This paper examines the economics of tailored pharmacy interventions to improve medication adherence for cardiovascular disease prevention and management. METHODS: Literature from inception of databases to May 2019 was searched, yielding 29 studies for cardiovascular disease prevention and 9 studies for cardiovascular disease management. Analyses were done from June 2019 through May 2020. All monetary values are in 2019 U.S. dollars. RESULTS: The median intervention cost per patient per year was $246 for cardiovascular disease prevention and $292 for cardiovascular disease management. The median change in healthcare cost per person per year due to the intervention was -$355 for cardiovascular disease prevention and -$2,430 for cardiovascular disease management. The median total cost per person per year was -$89 for cardiovascular disease prevention, with a median return on investment of 0.01. The median total cost per person per year for cardiovascular disease management was -$1,080, with a median return on investment of 7.52, and 6 of 7 estimates indicating reduced healthcare cost averted exceeded intervention cost. For cardiovascular disease prevention, the median cost per quality-adjusted life year gained was $11,298. There were no cost effectiveness studies for cardiovascular disease management. DISCUSSION: The evidence shows that tailored pharmacy-based interventions to improve medication adherence are cost effective for cardiovascular disease prevention. For cardiovascular disease management, healthcare cost averted exceeds the cost of implementation for a favorable return on investment from a healthcare systems perspective. |
Systematic Review of Self-Measured Blood Pressure Monitoring With Support: Intervention Effectiveness and Cost
Shantharam SS , Mahalingam M , Rasool A , Reynolds JA , Bhuiya AR , Satchell TD , Chapel JM , Hawkins NA , Jones CD , Jacob V , Hopkins DP . Am J Prev Med 2021 62 (2) 285-298 INTRODUCTION: Self-measured blood pressure monitoring with support is an evidence-based intervention that helps patients control their blood pressure. This systematic economic review describes how certain intervention aspects contribute to effectiveness, intervention cost, and intervention cost per unit of the effectiveness of self-measured blood pressure monitoring with support. METHODS: Papers published between data inception and March 2021 were identified from a database search and manual searches. Papers were included if they focused on self-measured blood pressure monitoring with support and reported blood pressure change and intervention cost. Papers focused on preeclampsia, kidney disease, or drug efficacy were excluded. Quality of estimates was assessed for effectiveness, cost, and cost per unit of effectiveness. Patient characteristics and intervention features were analyzed in 2021 to determine how they impacted effectiveness, intervention cost, and intervention cost per unit of effectiveness. RESULTS: A total of 22 studies were included in this review from papers identified in the search. Type of support was not associated with differences in cost and cost per unit of effectiveness. Lower cost and cost per unit of effectiveness were achieved with simple technologies such as interactive phone systems, smartphones, and websites and where providers interacted with patients only as needed. DISCUSSION: Some of the included studies provided only limited information on key outcomes of interest to this review. However, the strength of this review is the systematic collection and synthesis of evidence that revealed the associations between the characteristics of implemented interventions and their patients and the interventions' effectiveness and cost, a useful contribution to the fields of both research and implementation. |
Timing of State and Territorial COVID-19 Stay-at-Home Orders and Changes in Population Movement - United States, March 1-May 31, 2020.
Moreland A , Herlihy C , Tynan MA , Sunshine G , McCord RF , Hilton C , Poovey J , Werner AK , Jones CD , Fulmer EB , Gundlapalli AV , Strosnider H , Potvien A , García MC , Honeycutt S , Baldwin G . MMWR Morb Mortal Wkly Rep 2020 69 (35) 1198-1203 SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is thought to spread from person to person primarily by the respiratory route and mainly through close contact (1). Community mitigation strategies can lower the risk for disease transmission by limiting or preventing person-to-person interactions (2). U.S. states and territories began implementing various community mitigation policies in March 2020. One widely implemented strategy was the issuance of orders requiring persons to stay home, resulting in decreased population movement in some jurisdictions (3). Each state or territory has authority to enact its own laws and policies to protect the public's health, and jurisdictions varied widely in the type and timing of orders issued related to stay-at-home requirements. To identify the broader impact of these stay-at-home orders, using publicly accessible, anonymized location data from mobile devices, CDC and the Georgia Tech Research Institute analyzed changes in population movement relative to stay-at-home orders issued during March 1-May 31, 2020, by all 50 states, the District of Columbia, and five U.S. territories.* During this period, 42 states and territories issued mandatory stay-at-home orders. When counties subject to mandatory state- and territory-issued stay-at-home orders were stratified along rural-urban categories, movement decreased significantly relative to the preorder baseline in all strata. Mandatory stay-at-home orders can help reduce activities associated with the spread of COVID-19, including population movement and close person-to-person contact outside the household. |
Translating workforce development policy interventions for community health workers: Application of a policy research continuum
Fulmer EB , Barbero C , Gilchrist S , Shantharam SS , Bhuiya AR , Taylor LN , Jones CD . J Public Health Manag Pract 2020 26 Suppl 2 S10-s18 CONTEXT: There is a need for knowledge translation to advance health equity in the prevention and control of cardiovascular disease and type 2 diabetes. One recommended strategy is engaging community health workers (CHWs) to have a central role in related interventions. Despite strong evidence of effectiveness for CHWs, there is limited information examining the impact of state CHW policy interventions. This article describes the application of a policy research continuum to enhance knowledge translation of CHW workforce development policy in the United States. METHODS: During 2016-2019, a team of public health researchers and practitioners applied the policy research continuum, a multiphased systematic assessment approach that incorporates legal epidemiology to enhance knowledge translation of CHW workforce development policy interventions in the United States. The continuum consists of 5 discrete, yet interconnected, phases including early evidence assessments, policy surveillance, implementation studies, policy ratings, and impact studies. RESULTS: Application of the first 3 phases of the continuum demonstrated (1) how CHW workforce development policy interventions are linked to strong evidence bases, (2) whether existing state CHW laws are evidence-informed, and (3) how different state approaches were implemented. DISCUSSION: As a knowledge translation tool, the continuum enhances dissemination of timely, useful information to inform decision making and supports the effective implementation and scale-up of science-based policy interventions. When fully implemented, it assists public health practitioners in examining the utility of different policy intervention approaches, the effects of adaptation, and the linkages between policy interventions and more distal public health outcomes. |
A replicable approach to promoting best practices: Translating cardiovascular disease prevention research
Hawkins NA , Bhuiya AR , Shantharam S , Chapel JM , Taylor LN , Thigpen S , Decker A , Moeti R , Bernard S , Jones CD , Schooley M . J Public Health Manag Pract 2020 27 (2) 109-116 OBJECTIVE: Significant delays in translating health care-related research into public health programs and medical practice mean that people may not get the best care when they need it. Regarding cardiovascular disease, translation delays can mean lives may be unnecessarily lost each year. To facilitate the translation of knowledge to action, we created a Best Practices Guide for Cardiovascular Disease Prevention Programs. DESIGN: Using the Rapid Synthesis Translation Process and the Best Practices Framework as guiding frameworks, we collected and rated research evidence for hypertension control and cholesterol management strategies. After identifying best practices, we gathered information about programs that were implementing the practices and about resources useful for implementation. Research evidence and supplementary information were consolidated in an informational resource and published online. Web metrics were collected and analyzed to measure use and reach of the guide. RESULTS: The Best Practices Guide was released in January 2018 and included background information and resources on 8 best practice strategies. It was published as an online resource, publicly accessible from the Centers for Disease Control and Prevention Web site in 2 different formats. Web metrics show that in the first year after publication, there were 25 589 Web page views and 2467 downloads. A query of partner use of the guide indicated that it was often shared in partners' own resources, newsletters, and online material. CONCLUSION: In following a systematic approach to creating the Best Practices Guide and documenting the steps taken in its development, we offer a replicable approach for translating research on health care practices into a resource to facilitate implementation. The success of this approach is attributed to 3 key factors: using a prescribed and documented approach to evidence translation, working closely with stakeholders throughout the process, and prioritizing the content design and accessibility of the final product. |
Economics of community health workers for chronic disease: Findings from Community Guide Systematic Reviews
Jacob V , Chattopadhyay SK , Hopkins DP , Reynolds JA , Xiong KZ , Jones CD , Rodriguez BJ , Proia KK , Pronk NP , Clymer JM , Goetzel RZ . Am J Prev Med 2019 56 (3) e95-e106 Context: Cardiovascular disease in the U.S. accounted for healthcare cost and productivity losses of $330 billion in 2013–2014 and diabetes accounted for $327 billion in 2017. The impact is disproportionate on minority and low-SES populations. This paper examines the available evidence on cost, economic benefit, and cost effectiveness of interventions that engage community health workers to prevent cardiovascular disease, prevent type 2 diabetes, and manage type 2 diabetes. Evidence acquisition: Literature from the inception of databases through July 2016 was searched for studies with economic information, yielding nine studies in cardiovascular disease prevention, seven studies in type 2 diabetes prevention, and 13 studies in type 2 diabetes management. Analyses were done in 2017. Monetary values are reported in 2016 U.S. dollars. Evidence synthesis: The median intervention cost per patient per year was $329 for cardiovascular disease prevention, $600 for type 2 diabetes prevention, and $571 for type 2 diabetes management. The median change in healthcare cost per patient per year was –$82 for cardiovascular disease prevention and –$72 for type 2 diabetes management. For type 2 diabetes prevention, one study saw no change and another reported –$1,242 for healthcare cost. One study reported a favorable 1.8 return on investment from engaging community health workers for cardiovascular disease prevention. Median cost per quality-adjusted life year gained was $17,670 for cardiovascular disease prevention, $17,138 (mean) for type 2 diabetes prevention, and $35,837 for type 2 diabetes management. Conclusions: Interventions engaging community health workers are cost effective for cardiovascular disease prevention and type 2 diabetes management, based on a conservative $50,000 benchmark for cost per quality-adjusted life year gained. Two cost per quality-adjusted life year estimates for type 2 diabetes prevention were far below the $50,000 benchmark. |
Community Guide Cardiovascular Disease Economic Reviews: Tailoring methods to ensure utility of findings
Chattopadhyay SK , Jacob V , Mercer SL , Hopkins DP , Elder RW , Jones CD . Am J Prev Med 2017 53 S155-s163 The Community Preventive Services Task Force recommended five interventions for cardiovascular disease prevention between 2012 and 2015. Systematic economic reviews of these interventions faced challenges that made it difficult to generate meaningful policy and programmatic conclusions. This paper describes the methods used to assess, synthesize, and evaluate the economic evidence to generate reliable and useful economic conclusions and address the comparability of economic findings across interventions. Specifically, steps were taken to assess completeness of data and identify the components and drivers of cost and benefit. Except for the intervention cost of self-measured blood pressure monitoring intervention, either alone or with patient support, all cost and benefit estimates were standardized as per patient per year. When possible, intermediate outcomes were converted to quality-adjusted life year. Differences within and between interventions were considered to generate economic conclusions and inform their comparability. The literature search period varied among interventions. This analysis was completed in 2016. Although team-based care, self-measured blood pressure monitoring with patient support, and self-measured blood pressure monitoring within team-based care were found to be cost effective, their cost-effectiveness estimates were not comparable because of differences in the intervention characteristics. Lack of enough data or incomplete information made it difficult to reach an overall economic finding for the other interventions. The Community Guide methods discussed here may help others conducting systematic economic reviews of public health interventions to respond to challenges with the synthesis of evidence and provide useful findings for public health decision makers. |
Economics of self-measured blood pressure monitoring: A Community Guide Systematic Review
Jacob V , Chattopadhyay SK , Proia KK , Hopkins DP , Reynolds J , Thota AB , Jones CD , Lackland DT , Rask KJ , Pronk NP , Clymer JM , Goetzel RZ . Am J Prev Med 2017 53 (3) e105-e113 CONTEXT: The health and economic burden of hypertension, a major risk factor for cardiovascular disease, is substantial. This systematic review evaluated the economic evidence of self-measured blood pressure (SMBP) monitoring interventions to control hypertension. EVIDENCE ACQUISITION: The literature search from database inception to March 2015 identified 22 studies for inclusion with three types of interventions: SMBP used alone, SMBP with additional support, and SMBP within team-based care (TBC). Two formulae were used to convert reductions in systolic BP (SBP) to quality-adjusted life years (QALYs) to produce cost per QALY saved. All analyses were conducted in 2015, with estimates adjusted to 2014 U.S. dollars. EVIDENCE SYNTHESIS: Median costs of intervention were $60 and $174 per person for SMBP alone and SMBP with additional support, respectively, and $732 per person per year for SMBP within TBC. SMBP alone and SMBP with additional support reduced healthcare cost per person per year from outpatient visits and medication (medians $148 and $3, respectively; median follow-up, 12-13 months). SMBP within TBC exhibited an increase in healthcare cost (median, $369 per person per year; median follow-up, 18 months). SMBP alone varied from cost saving to a maximum cost of $144,000 per QALY saved, with two studies reporting an increase in SBP. The two translated median costs per QALY saved were $2,800 and $4,000 for SMBP with additional support and $7,500 and $10,800 for SMBP within TBC. CONCLUSIONS: SMBP monitoring interventions with additional support or within TBC are cost effective. Cost effectiveness of SMBP used alone could not be determined. |
Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis
Zhang X , Devlin HM , Smith B , Imperatore G , Thomas W , Lobelo F , Ali MK , Norris K , Gruss S , Bardenheier B , Cho P , Garcia de Quevedo I , Mudaliar U , Jones CD , Durthaler JM , Saaddine J , Geiss LS , Gregg EW . PLoS One 2017 12 (5) e0176436 Structured lifestyle interventions can reduce diabetes incidence and cardiovascular disease (CVD) risk among persons with impaired glucose tolerance (IGT), but it is unclear whether they should be implemented among persons without IGT. We conducted a systematic review and meta-analyses to assess the effectiveness of lifestyle interventions on CVD risk among adults without IGT or diabetes. We systematically searched MEDLINE, EMBASE, CINAHL, Web of Science, the Cochrane Library, and PsychInfo databases, from inception to May 4, 2016. We selected randomized controlled trials of lifestyle interventions, involving physical activity (PA), dietary (D), or combined strategies (PA+D) with follow-up duration ≥12 months. We excluded all studies that included individuals with IGT, confirmed by 2-hours oral glucose tolerance test (75g), but included all other studies recruiting populations with different glycemic levels. We stratified studies by baseline glycemic levels: (1) low-range group with mean fasting plasma glucose (FPG) <5.5mmol/L or glycated hemoglobin (A1C) <5.5%, and (2) high-range group with FPG ≥5.5mmol/L or A1C ≥5.5%, and synthesized data using random-effects models. Primary outcomes in this review included systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides (TG). Totally 79 studies met inclusion criteria. Compared to usual care (UC), lifestyle interventions achieved significant improvements in SBP (-2.16mmHg[95%CI, -2.93, -1.39]), DBP (-1.83mmHg[-2.34, -1.31]), TC (-0.10mmol/L[-0.15, -0.05]), LDL-C (-0.09mmol/L[-0.13, -0.04]), HDL-C (0.03mmol/L[0.01, 0.04]), and TG (-0.08mmol/L[-0.14, -0.03]). Similar effects were observed among both low-and high-range study groups except for TC and TG. Similar effects also appeared in SBP and DBP categories regardless of follow-up duration. PA+D interventions had larger improvement effects on CVD risk factors than PA alone interventions. In adults without IGT or diabetes, lifestyle interventions resulted in significant improvements in SBP, DBP, TC, LDL-C, HDL-C, and TG, and might further reduce CVD risk. |
Tobacco use among middle and high school students - United States, 2013
Arrazola RA , Neff LJ , Kennedy SM , Holder-Hayes E , Jones CD . MMWR Morb Mortal Wkly Rep 2014 63 (45) 1021-1026 Tobacco use is the leading preventable cause of disease and death in the United States, and nearly all tobacco use begins during youth and young adulthood. Among U.S. youths, cigarette smoking has declined in recent years; however, the use of some other tobacco products has increased, and nearly half of tobacco users use two or more tobacco products. CDC analyzed data from the 2013 National Youth Tobacco Survey to determine the prevalence of ever (at least once) and current (at least 1 day in the past 30 days) use of one or more of 10 tobacco products (cigarettes, cigars, hookahs, smokeless tobacco, electronic cigarettes [e-cigarettes], pipes, snus, bidis, kreteks, and dissolvable tobacco) among U.S. middle school (grades 6-8) and high school (grades 9-12) students. In 2013, 22.9% of high school students reported current use of any tobacco product, and 12.6% reported current use of two or more tobacco products; current use of combustible products (i.e., cigarettes, cigars, pipes, bidis, kreteks, and/or hookahs) was substantially greater (20.7%) than use of other types of tobacco. Also, 46.0% of high school students reported having ever tried a tobacco product, and 31.4% reported ever trying two or more tobacco products. Among middle school students, 3.1% reported current use of cigars, and 2.9% reported current use of cigarettes, with non-Hispanic black students more than twice as likely to report current use of cigars than cigarettes. Monitoring the prevalence of the use of all available tobacco products, including new and emerging products, is critical to support effective population-based interventions to prevent and reduce tobacco use among youths as part of comprehensive tobacco prevention and control programs. |
Corrigendum to “Trends in Traumatic Brain Injury in the U.S. and the public health response: 1995–2009"
Greenspan A I , Coronado VG , McGuire LC , Sarmiento K , Bell J , Lionbarger MR , Jones CD , Geller AI , Khoury N , Xu L . J Safety Res 2014 48 117 In the article Trends in Traumatic Brain Injury in the U.S. and the public health response: 1995–2009, by Victor G. Coronado et al., (Journal of Safety Research, Vol 43/Issue 4, pp 299–307, September, 2012) an error was made in the calculation of total traumatic brain injury (TBI) burden. The authors incorrectly included the number of outpatient visits and office-based visits to an estimate of the total number of patients with a primary or secondary diagnosis of TBI in 2009. While an average of 1.2 million visits (annualized average between 2007 and 2009) are made each year to outpatient departments or to office-based physicians for treatment related to a TBI, either alone or in combination with other injuries, it is impossible to identify how many of these were incident visits versus repeat or follow-up visits. By including outpatient department and office-based visits we likely overestimated their contribution to the total TBI burden. While we recognize that excluding these visits from the overall estimate eliminates some incident cases and results in an underestimate of total TBI burden, the estimate of ED visits, hospitalizations, and deaths is more precise and should be presented separately from outpatient and office-based visits. Thus, the correct estimates should read: “In 2009, there were approximately 2.4 million hospital emergency department (ED) visits, hospitalizations, or deaths related to a TBI, either alone or in combination with other injuries. Further, between 2007 and 2009 there was an annualized average of 1.1 million office-based visits and 84,000 outpatient department visits with a TBI-related diagnosis either alone or in combination with other injuries.” Our incorrect calculation which combined outpatient and office-based visits with ED visits, hospitalizations, and deaths can be found in the first line of the Abstract, (page 299 of the printed version); in the second paragraph of section 5 (page 302); and in the third line of the Conclusions and recommendations section (page 305); these numbers (3.5 million, 3.6 million, and 3.6 million, respectively) were incorrect. The Centers for Disease Control and Prevention will be using the corrected estimate of 2.4 million to describe the national burden of TBI (ED visits, hospitalizations, and deaths) in future descriptions for 2009. We continue to pursue methods to identify incident cases of TBI that do not present to EDs to more comprehensively capture the full TBI burden. |
Trends in traumatic brain injury in the U.S. and the public health response: 1995–2009
Coronado VG , McGuire LC , Sarmiento K , Bell J , Lionbarger MR , Jones CD , Geller AI , Khoury N , Xu L . J Safety Res 2012 43 (4) 299-307 Problem Traumatic Brain Injury (TBI) is a public health problem in the United States. In 2009, approximately 3.5 million patients with a TBI listed as primary or secondary diagnosis were hospitalized and discharged alive (N = 300,667) or were treated and released from emergency departments (EDs; N = 2,077,350), outpatient departments (ODs; N = 83,857), and office-based physicians (OB-P; N = 1,079,338). In addition, 52,695 died with one or more TBI-related diagnoses. Methods Federal TBI-related laws that have guided CDC since 1996 were reviewed. Trends in TBI were obtained by analyzing data from nationally representative surveys conducted by the National Center for Health Statistics (NCHS). Findings CDC has developed and is implementing a strategy to reduce the burden of TBI in the United States. Currently, 20 states have TBI surveillance and prevention systems. From 1995–2009, the TBI rates per 100,000 population increased in EDs (434.1 vs. 686.0) and OB-Ps (234.6 vs. 352.3); and decreased in ODs (42.6 vs. 28.1) and in TBI-related deaths (19.9 vs. 16.6). TBI Hospitalizations decreased from 95.5 in 1995 to 77.9 in 2000 and increased to 95.7 in 2009. Conclusions The rates of TBI have increased since 1995 for ED and PO visits. To reduce of the burden and mitigate the impact of TBI in the United States, an improved state- and territory-specific TBI surveillance system that accurately measures burden and includes information on the acute and long-term outcomes of TBI is needed. |
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