Goal 3: Advance Translational Research

Integrated Clinical Guideline on Comorbidities in Primary Care

The development of systematic evidence reviews (SER) that provide the evidence that partner organizations can use to develop an integrated clinical practice guideline for use by primary care providers for the treatment of patients with single and multiple conditions for the primary and secondary prevention of heart, lung, blood, and sleep (heart, lung, blood, sleep) diseases.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

• Despite the success of single condition/disease guidelines, patients often have multiple conditions/risk factors that interact in various ways and can accelerate the development of atherosclerosis and chronic lung diseases. Effective management therefore requires a more integrated approach to assessment and treatment that spans all of relevant risk factors and conditions.
• The development of an integrated guideline has been recommended by participants in several NHLBI forums, including the NHLBI Strategic Planning process, the NHLBI Conference to Create a Cardiovascular Knowledge Network, and the Cardiovascular Disease Thought Leaders Meeting.

Feasibility and challenges of addressing this CQ or CC

Feasibility: • NHLBI currently participates with other Institutes in funding research on comorbidities, Behavioral Interventions to Address Multiple Chronic Health Conditions in Primary Care (R01, PA-12-024).
• An increasing number of scholarly articles are addressing the magnitude and cost of the problem and calling for guidelines that address this reality.

Challenges: .

• Few studies have focused on the management of patients with multiple chronic conditions.

• Clinical research often excludes persons with multiple chronic conditions.

Name of idea submitter and other team members who worked on this idea NHLBI Staff



1 net vote
12 up votes
11 down votes
Idea No. 218