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PERSONAL DIGITAL ASSISTANT FOR GUIDELINE ADHERENCE TRIAL

Award Number: R01HL070742
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: HEALTH SERVICES
PERIOD OF PERFORMANCE START DATE: 09/03/2002
PERIOD OF PERFORMANCE END DATE: 08/31/2007

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PERSONAL DIGITAL ASSISTANT FOR GUIDELINE ADHERENCE TRIAL - DESCRIPTION (provided by the applicant): The goal of the proposed trial is to test the impact of a novel practice-based intervention, including the use of personal digital assistant (PDA) based decision support, on adherence with a complex clinical practice guideline (CPG) in primary carepractices. We have chosen the Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP 111) guideline as it is complex, including screening criteria, risk stratification, and risk-group specific treatment recommendations. This randomized, controlled practice-based trial will test the primary hypothesis that intervention practices will have a net increase in the proportion of screened adults that is treated appropriately with lipid-lowering drug therapy. We will estimate the marginal cost effectiveness of the intervention for this primary endpoint. Other outcomes will include the proportions of patients that is appropriately 1) controlled to low density lipoprotein cholesterol goal, 2) screened, 3) risk-stratified, and 4) counseled regarding therapeutic lifestyle changes. We will explore the intervention effect on disparities in care observed at baseline. The intervention will be delivered at the level of randomization (the practice) and will include academic detailing and training on use of the PDA-based decision support tool. All practices (n=64) will receive usual care, consisting of guideline dissemination, baseline performance feedback, and continuing education. Outcomes will be assessed based on patient level data from baseline and follow-up chart reviews of adult patients (N-20,000) eligible for cholesterol measurement. Appropriate methods will be used to analyze these correlated data. Impact evaluation will be conducted via baseline and follow-up surveys of participating physicians and staff. Process evaluation will be conducted by tracking use of the PDA-based tool. We estimate as many as 48,000 major CHD events could be averted annually in the US with sufficiently improved adherence to ATPIII. If this intervention is successful, electronic decision support tools could be used to facilitate implementation of other complex CPGs. Hence, this innovative strategy holds great promise for making a substantial public health impact through the prevention of CVD and through subsequent translation to other important conditions.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2006 ( Subtotal = $821,403 )
2006	2006	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BOULEVARD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cardiovascular Diseases Research	000	5	7/28/2006	NON-COMPETING CONTINUATION	$821,403
														Subtotal = $821,403

Issue Date FY: 2005 ( Subtotal = $584,666 )
2005	2005	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BOULEVARD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cardiovascular Diseases Research	000	4	8/15/2005	NON-COMPETING CONTINUATION	$584,666
														Subtotal = $584,666

Issue Date FY: 2004 ( Subtotal = $509,775 )
2004	2004	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BOULEVARD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cardiovascular Diseases Research	000	3	9/13/2004	NON-COMPETING CONTINUATION	$509,775
														Subtotal = $509,775

Issue Date FY: 2003 ( Subtotal = $1,056,717 )
2003	2003	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BOULEVARD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cardiovascular Diseases Research	000	2	8/1/2003	NON-COMPETING CONTINUATION	$984,886
2003	2003	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BOULEVARD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cardiovascular Diseases Research	001	2	9/30/2003	SUPPLEMENT FOR EXPANSION	$71,831
														Subtotal = $1,056,717

Issue Date FY: 2002 ( Subtotal = $585,335 )
2002	2002	WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE	MEDICAL CENTER BOULEVARD	WINSTON-SALEM	NC	27157		USA	Cardiovascular Diseases Research	000	1	9/3/2002	NEW	$585,335
														Subtotal = $585,335

Grand Total All Awards = $3,557,896

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PERSONAL DIGITAL ASSISTANT FOR GUIDELINE ADHERENCE TRIAL

Award Number: R01HL070742

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: HEALTH SERVICES

PERIOD OF PERFORMANCE START DATE: 09/03/2002

PERIOD OF PERFORMANCE END DATE: 08/31/2007

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