Friday, September 11, 2015

Today's Landmark NHLBI SPRINT study results relate to this 2008 PI-CME article by Shershneva, Olson, et al

Today the National Heart, Lung, and Blood Institute (NHLBI) of the United States National Institutes of Health announced the early completion of the landmark SPRINT study into recommended systolic blood pressure, which was led by researchers in my own town, at Wake Forest University School of Medicine. Therefore I am featuring a hypertension performance-improvement CME study by Marianna Shershneva, Curt Olson, and others, whose care is a quality measure in this country and elsewhere.

This PI-CME study was published in 2008, before most educational providers who now have outcomes-reporting capacities were able to study educational outcomes within a clinical context. Marianna Shershneva, M.D., Ph.D., is Building Block Leader for Quality Metrics of the Alliance's Quality Improvement Education (ACEhp QIE) Initiative, and Curtis Olson, Ph.D., has been guiding our field through his influence and tenure as Editor-in-Chief of the Journal of Continuing Education in the Health Professions. With their coauthors, Elizabeth Mullikin and Anne-Sophie Loos, we have a nice study for historical review that might have escaped attention on this day because the article title does not specify hypertension.

Consider this excerpt from the abstract, which lays out the opportunities for quality improvement professionals and clinical educators to work together for better patient care: "Although QI practices and CME approaches have been recognized for years, what emerges from their integration is largely unfamiliar, because it requires the collaboration of CME providers and stakeholders within the health care systems who traditionally have not worked together and may not have the same understanding of QI issues to close performance gaps." This was an observational case study with nine clinicians completing the study, and while we could wish for a larger sample, we should agree with the authors that "PI CME required unprecedented collaboration between CME planners and QI stakeholders to enable change in clinical practice." Let's applaud the effort and enjoy the three core findings that you'll see if you access this article.

This is a FREE article in PubMed Central, and I encourage you to review it for findings on physicians' practice patterns that have bearing on today's news from NHLBI. Thanks to the National Library of Medicine reviewers of articles for their assignments to this article's medical subject headings (MeSH terms), without which this article may not have risen to most noteworthy mention after today's NHLBI news. And by the way, proving the relevance of this sort of work to our nation, this study was also funded by two NIH grants.

References Cited: Shershneva MB, Mullikin EA, Loose A-S, Olson CA. Learning to collaborate: a case study of performance improvement CME. J Contin Educ Health Prof. 2008;28(3):140-147. doi:10.1002/chp.181.
NHLBI. Landmark NIH study shows intensive blood pressure management may save lives: lower blood pressure target greatly reduces cardiovascular complications and deaths in older adults [press release]. NHLBI Website. http://www.nih.gov/news/health/sep2015/nhlbi-11.htm. Accessed September 11, 2015.
Reboussin D, NHLBI, NIDDK, NINDS, and NIA. Systolic Blood Pressure Intervention Trial (SPRINT). NCT01206062. ClinicalTrials.gov Website. https://clinicaltrials.gov/ct2/show/NCT01206062. Accessed Accessed September 11, 2015.
MeSH *Major* Terms: Education, Medical, Continuing/standards; Hypertension/prevention & control; Physician's Practice Patterns; Quality Assurance, Health Care.

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