VIEWPOINT
From knowledge to practice in chronic cardiovascular disease: a long and winding road
Sumit R. Majumdar, MD, MPH*,
Finlay A. McAlister, MD, MSc*,* and
Curt D. Furberg, MD, PhD
* Division of General Internal Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
Manuscript received November 3, 2003;
revised manuscript received December 18, 2003,
accepted December 23, 2003.
* Reprint requests and correspondence: Dr. Finlay A. McAlister, Division of General Internal Medicine, Department of Medicine, University of Alberta, 2E3.24 Walter Mackenzie Health Sciences Centre, 8440-112th Street, Edmonton, Alberta, Canada, T6G 2B7.
finlay.mcalister{at}ualberta.ca
Although clinical practices evolve over time, the translation of specific research evidence into clinical practice is unpredictable, inconsistent, and complex. In this paper, we use examples from chronic cardiovascular conditions to: 1) highlight two types of care gaps; 2) describe the most common potential barriers to the application of evidence into clinical care; and 3) outline which of the strategies for translating evidence into clinical care have been shown to be ineffective, which strategies have been shown to be effective and to describe some untested approaches that hold promise.
|
Abbreviations and Acronyms
| | ACE | = angiotensin-converting enzyme | | HF | = heart failure | | HOPE | = Heart Outcomes Prevention and Evaluation study | | MI | = myocardial infarction | | RCT | = randomized clinical trial |
|
This article has been cited by other articles:
|
|
|
|
 
J. F. Kerner and K. L. Hall
Research Dissemination and Diffusion: Translation Within Science and Society
Research on Social Work Practice,
September 1, 2009;
19(5):
519 - 530.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. E. Straus, J. Tetroe, and I. Graham
Defining knowledge translation
Can. Med. Assoc. J.,
August 4, 2009;
181(3-4):
165 - 168.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. K. Bartholomew, W. C Cushman, J. A Cutler, B. R Davis, G. Dawson, P. T Einhorn, J. F Graumlich, L. B Piller, S. Pressel, E. J Roccella, et al.
Getting clinical trial results into practice: design, implementation, and process evaluation of the ALLHAT Dissemination Project
Clinical Trials,
August 1, 2009;
6(4):
329 - 343.
[Abstract]
[PDF]
|
|
|
|
|
|
|
R. D. Feldman and F. A. McAlister
Postgame Wrap of the Ultimate Blood Pressure Megatrial: Did It Score an ALLHAT Trick or Was It "Three Strikes and You're Out?"
Hypertension,
April 1, 2009;
53(4):
595 - 597.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Windak, B. Gryglewska, T. Tomasik, K. Narkiewicz, and T. Grodzicki
Competence of General Practitioners in Giving Advice about Changes in Lifestyle to Hypertensive Patients
Med Decis Making,
March 1, 2009;
29(2):
217 - 223.
[Abstract]
[PDF]
|
|
|
|
|
|
|
B. Shah, A. F. Hernandez, L. Liang, S. M. Al-Khatib, C. W. Yancy, G. C. Fonarow, E. D. Peterson, and on behalf of the Get With The Guidelines Steering
Hospital Variation and Characteristics of Implantable Cardioverter-Defibrillator Use in Patients With Heart Failure Data From the GWTG-HF (Get With The Guidelines-Heart Failure) Registry.
J. Am. Coll. Cardiol.,
February 3, 2009;
53(5):
416 - 422.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. G. Planas
Intervention design, implementation, and evaluation
Am. J. Health Syst. Pharm.,
October 1, 2008;
65(19):
1854 - 1863.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Naughton, J. Feely, and K. Bennett
A clustered randomized trial of the effects of feedback using academic detailing compared to postal bulletin on prescribing of preventative cardiovascular therapy
Fam. Pract.,
October 1, 2007;
24(5):
475 - 480.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. A. McAlister, A. Oreopoulos, C. M. Norris, M. M. Graham, R. T. Tsuyuki, M. Knudtson, W. A. Ghali, and for the Alberta Provincial Project for Outcome Ass
Exploring the Treatment-Risk Paradox in Coronary Disease
Arch Intern Med,
May 28, 2007;
167(10):
1019 - 1025.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Rucker, J. A. Johnson, T.K. Lee, D. T. Eurich, R. Z. Lewanczuk, S. H. Simpson, E. L. Toth, and S. R. Majumdar
The Natural History of LDL Control in Type 2 Diabetes: A prospective study of adherence to lipid guidelines.
Diabetes Care,
November 1, 2006;
29(11):
2506 - 2508.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P B Marck, J A Kwan, B Preville, M Reynes, W Morgan-Eckley, R Versluys, L Chivers, B O'Brien, J Van der Zalm, M Swankhuizen, et al.
Building safer systems by ecological design: using restoration science to develop a medication safety intervention.
Qual. Saf. Health Care,
April 1, 2006;
15(2):
92 - 97.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. J. Hankey, P. E. Norman, and J. W. Eikelboom
Medical Treatment of Peripheral Arterial Disease
JAMA,
February 1, 2006;
295(5):
547 - 553.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. R.C. Campbell, K. Tu, R. Brant, M. Duong-Hua, F. A. McAlister, and for the Canadian Hypertension Education Program Ou
The Impact of the Canadian Hypertension Education Program on Antihypertensive Prescribing Trends
Hypertension,
January 1, 2006;
47(1):
22 - 28.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Clark, L. Hartling, B. Vandermeer, and F. A. McAlister
Meta-Analysis: Secondary Prevention Programs for Patients with Coronary Artery Disease
Ann Intern Med,
November 1, 2005;
143(9):
659 - 672.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A M Clark, I N Findlay, and for the Have a Heart Paisley IT Group
Improving evidence based cardiac care and policy implementation over the patient journey: the potential of coronary heart disease registers
Heart,
September 1, 2005;
91(9):
1127 - 1130.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. A. McAlister, E. Wooltorton, N. R.C. Campbell, and for The Canadian Hypertension Education Program
The Canadian Hypertension Education Program (CHEP) recommendations: launching a new series
Can. Med. Assoc. J.,
August 30, 2005;
173(5):
508 - 509.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. W. Mold and K. A. Peterson
Primary Care Practice-Based Research Networks: Working at the Interface Between Research and Quality Improvement
Ann. Fam. Med,
May 1, 2005;
3(suppl_1):
S12 - S20.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. S. Rumsfeld and E. D. Peterson
Care disparities: Moving from gray to black and white
J. Am. Coll. Cardiol.,
January 4, 2005;
45(1):
79 - 81.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. S. Rumsfeld and F. A. Masoudi
Heart failure disease management works, but will it succeed?
Eur. Heart J.,
September 2, 2004;
25(18):
1565 - 1567.
[Full Text]
[PDF]
|
|
|
|
