Heart Failure Patient Quality Of Care Improves At Hospitals In The Get With The Guidelines(SM) Program
Previous studies have documented large gaps in the quality of care provided to patients hospitalized with heart failure. There are a number of very effective therapies for patients with heart failure, but under-use of these recommended treatments contribute to a significant number of unnecessary and costly hospitalizations of patients with heart failure and serious mortality risk.
GWTG, based on the American College of Cardiology and American Heart Association practice guidelines, helps hospitals close the gap between recommended treatment and actual treatment of patients with coronary heart disease, stroke, and heart failure. The program emphasizes protocols created to ensure cardiovascular patients are cared for according to nationally accepted standards and the latest evidence-based guidelines and recommendations. Hospitals implementing the program generally see measurable improvements in the quality of care in a short period of time. While benefits have been observed for patients hospitalized with coronary artery disease and those with stroke, it was not previously know if GWTG could favorably influence the care of patients hospitalized with heart failure.
Heart failure is a progressive condition in which the heart muscle becomes weakened for example from high blood pressure or a heart attack, and gradually loses the ability to pump enough blood to supply the body sufficiently. It is common but under-recognized and often misdiagnosed. Heart failure affects about 5 million Americans and 550,000 people are newly diagnosed with the condition each year.
These new American Heart Association studies analyzed data from 97 hospitals participating in the GWTG-Heart Failure program and 18,516 heart failure patients in those hospitals. The data reported in these two studies was collected between January 2005 and March 2006 on five specific performance measures: providing complete heart failure discharge instructions, measurement and documentation of heart function, use of recommended heart failure medications known as angiotensin converting enzyme (ACE inhibitors) or angiotensin receptor blocker (ARB), use of recommended heart failure medications know as beta blockers, and smoking cessation counseling for current or recent smokers.
The first study examined GWTG's influence on the quality of care of patients hospitalized with heart failure. Significant improvements were observed over four quarters in four of the five performance measures. Improvements were seen in use of ACE inhibitors/ARB, beta blockers, discharge instructions, and smoking cessation counseling. Measurement of left ventricular function started off at a level above 90 percent, but did not improve further.
Principle Investigator for both studies Gregg C. Fonarow, M.D., director of the Ahmanson-UCLA Cardiomyopthy Center and chairman of the Get With The Guidelines Steering Committee, said, "Get With The Guidelines participation has now been shown to be associated with significant improvements in the quality of care for patients hospitalized with heart failure. This enhanced care should result in substantial improvements in clinical outcomes."
The second study reviewed the same data for a defect free "complete care" metric. The complete care measure was defined as the percentage of patients who received each and every guideline-indicated care element for which they were eligible. Overall with GWTG, 64.6 percent of the patients received all eligible program guidelines. This improved over time from 60.3 percent to 68.6 percent, a result that was both statistically significant and clinically relevant.
Fonarow said hospitals participating in GWTG "significantly improved the reliability of heart failure patient care over time." Participation in GWTG can help hospitals improve the use of evidence-based therapies, meet national requirements, and minimize variations between hospitals. He noted, however, that with at least one missed opportunity for complete care in up to 35 percent of patients, further efforts are needed to enhance the reliability of heart failure care delivery.
GWTG - Heart Failure and these studies were sponsored in part by GlaxoSmithKline.
Additional study authors include: Kenneth A. LaBresh, M.D.; Clyde Yancy, M.D.; Nancy M. Albert, Ph.D.; Gray Ellrodt, M.D.; Adrian F. Hernandez, M.D.; Li Lang, M.D.; and Eric D. Peterson, M.D.
About Get With The Guidelines(SM)
GWTG helps hospitals align their care for coronary artery disease, stroke and heart failure patients with the latest scientific guidelines and the tools needed for improving the management of these patients. Through the GWTG three modules -- GWTG Heart Failure, GWTG Stroke, and GWTG Coronary Artery Disease (CAD) -- cardiologists, neurologists, primary care physicians, nurses and pharmacists are encouraged to work as a team in implementing guidelines based care.
Used by more than 1,240 hospitals nationwide since it inception in 2000, GWTG is the first hospital-based program to receive the Innovation in Prevention award from the Health and Human Services Department in 2004. GWTG initially introduced the CAD module and later launched the Heart Failure module in 2005. To learn more about GWTG, visit http://www.americanheart.org/getwiththeguidelines.
American Heart Association
http://www.americanheart.org
http://www.americanheart.org/getwiththeguidelines
Insuficienþã cardiacã pacientului calitatea îngrijirilor Îmbunãtãþeºte La spitale din Ia cu orientãrile (SM) Program - Heart Failure Patient Quality Of Care Improves At Hospitals In The Get With The Guidelines(SM) Program - articole medicale engleza - startsanatate