Evidence map›Paper›PMID 23635809›Full record

Trial reportThe Journal of cardiovascular nursing2014

Cost-effectiveness of nurse practitioner/community health worker care to reduce cardiovascular health disparities.

Jerilyn K Allen, Cheryl R Dennison Himmelfarb, Sarah L Szanton, Kevin D Frick

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Journal of cardiovascular nursing, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 4 pooled it
3.7field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 4 syntheses or guidelines pooled it, 91 citations in OpenAlex.

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  15. Community of Practice ofFrontiers in public health · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Jerilyn K AllenJerilyn K. Allen, RN, ScD, FAAN M Adelaide Nutting Professor of Nursing, Public Health and Medicine and Associate Dean for Research, School of Nursing, Johns Hopkins University, Baltimore, Maryland. Cheryl R. Dennison Himmelfarb, RN, ANP, PhD, FAAN Associate Professor, School of Nursing and Medicine, Johns Hopkins University, Baltimore, Maryland. Sarah L. Szanton, PhD, CRNP Associate Professor, School of Nursing, Johns Hopkins University, Baltimore, Maryland. Kevin D. Frick, PhD, MA Professor, Bloomberg School of Public Health and School of Nursing, Johns Hopkins University, Baltimore, Maryland.
Cheryl R Dennison Himmelfarb
Sarah L Szanton
Kevin D Frick
Johns Hopkins University · US

Funding

JHU-UMD Diabetes Research CenterP30DK079637 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI AHIMA, REXFORD S. · 2013 to 2017
$9.7M
Reducing Total Cardiovascular Risk in an Urban CommunityR01HL082638 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI ALLEN, JERILYN K · 2005 to 2009
$3.9M
NHLBI NIH HHS R01 HL082638NHLBI NIH HHS R01HL082638NIDDK NIH HHS P30 DK079637
6 · The paper itself

Abstract

backgroundAlthough evidence-based guidelines on the management of cardiovascular disease (CVD) and type 2 diabetes have been widely published, implementation of recommended therapies is suboptimal.

objectiveThe aim of this study was to evaluate the cost-effectiveness of a comprehensive program of CVD risk reduction delivered by nurse practitioner/community health worker (NP/CHW) teams versus enhanced usual care to improve lipids, blood pressure (BP), and hemoglobin (Hb) A1c levels in patients in urban community health centers.

methodsA total of 525 patients with documented CVD, type 2 diabetes, hypercholesterolemia, or hypertension and levels of low-density lipoprotein cholesterol, BP, or Hb A1c that exceeded goals established by national guidelines were randomized to NP/CHW (n = 261) or enhanced usual care (n = 264) groups. Cost-effectiveness ratios were calculated, determining costs per percent and unit change in the primary outcomes.

resultsThe mean incremental total cost per patient (NP/CHW and physician) was only $627 (confidence interval, 248-1015). The cost-effectiveness of the 1-year intervention was $157 for every 1% drop in systolic BP and $190 for every 1% drop in diastolic BP, $149 per 1% drop in Hb A1c, and $40 per 1% drop in low-density lipoprotein cholesterol.

conclusionsThe findings suggest that management by an NP/CHW team is a cost-effective approach for community health centers to consider in improving the care of patients with existing CVD or at high risk for the development of CVD.

Indexed as

Healthcare DisparitiesAdultAgedCardiovascular DiseasesCardiovascular NursingCommunity-Based Participatory ResearchCommunity Health ServicesCommunity Health WorkersDiabetes Mellitus, Type 2FemaleHumansHypercholesterolemiaHypertensionMaleMiddle Aged

Identifiers

PMID23635809
PMCPMC3766479
OpenAlexW2328018413

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.