Implementation Science to Achieve Equity in Heart Failure Care: A Scientific Statement From the American Heart Association.
Circulation
; 149(19): e1143-e1163, 2024 May 07.
Article
en En
| MEDLINE
| ID: mdl-38567497
ABSTRACT
Guideline-directed medical therapies and guideline-directed nonpharmacological therapies improve quality of life and survival in patients with heart failure (HF), but eligible patients, particularly women and individuals from underrepresented racial and ethnic groups, are often not treated with these therapies. Implementation science uses evidence-based theories and frameworks to identify strategies that facilitate uptake of evidence to improve health. In this scientific statement, we provide an overview of implementation trials in HF, assess their use of conceptual frameworks and health equity principles, and provide pragmatic guidance for equity in HF. Overall, behavioral nudges, multidisciplinary care, and digital health strategies increased uptake of therapies in HF effectively but did not include equity goals. Few HF studies focused on achieving equity in HF by engaging stakeholders, quantifying barriers and facilitators to HF therapies, developing strategies for equity informed by theory or frameworks, evaluating implementation measures for equity, and titrating strategies for equity. Among these HF equity studies, feasibility was established in using various educational strategies to promote organizational change and equitable care. A couple include ongoing randomized controlled pragmatic trials for HF equity. There is great need for additional HF implementation trials designed to promote delivery of equitable guideline-directed therapy.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_desigualdade_iniquidade
Asunto principal:
Equidad en Salud
/
American Heart Association
/
Ciencia de la Implementación
/
Insuficiencia Cardíaca
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Circulation
Año:
2024
Tipo del documento:
Article