Cynthia M. Boyd|Bruce Leff|Jennifer L. Wolff|Qilu Yu|Jing Zhou|Cynthia M. Rand|Carlos O. Weiss
Informing Clinical Practice Guideline Development and Implementation: Prevalence of Coexisting Conditions Among Adults with Coronary Heart Disease
Johns Hopkins University|National Center for Geriatrics and Gerontology|Johns Hopkins University|National Center for Geriatrics and Gerontology|Johns Hopkins University|National Center for Geriatrics and Gerontology|National Center for Geriatrics and Gerontology|Johns Hopkins University|Walter Reed National Military Medical Center|Pulmonary Associates|National Center for Geriatrics and Gerontology|Johns Hopkins University
objectives describe prevalence coexisting conditions affect clinical decisionmaking adults coronary heart disease chd design crosssectional setting national health nutrition examination survey 1999 2004 participants eight thousand six hundred fiftyfour people aged 45 older 1259 chd measurements coexisting conditions relevant clinical decisionmaking implementing therapy chd across three domains chronic diseases selfreported laboratorybased clinical measures health status factors selfreported observed function prevalence estimated according sex age mutually exclusive patterns examined odds ratios incurred repeated hospitalization last year participants chd complexity pattern versus chd alone modeled results prevalence comorbid chronic diseases subjects chd 567 arthritis 290 congestive heart failure 255 chronic lower respiratory tract disease 248 diabetes mellitus 138 stroke clinical factors adding complexity clinical decisionmaking chd use four medications 545 urinary incontinence 486 dizziness falls 348 low glomerular filtration rate 244 anemia 101 high alanine aminotransferase 59 use warfarin 102 health status factors cognitive impairment 299 mobility difficulty 404 frequent mental distress 143 visual impairment 167 hearing impairment 179 several comorbidity patterns associated high odds hospitalization conclusion coexisting conditions may modify effectiveness interact chd therapies influence feasibility chd therapies alter patients priorities concerning health care considered development trials guidelines better inform realworld clinical decisionmaking