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Cited by 425

The DOI matches its Crossref record; 2 of the 2 references it cites were found in a registry or an index.

Improving Evidence-Based Care for Heart Failure in Outpatient Cardiology Practices: Primary Results of the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF)

Fonarow, Gregg C., Albert, Nancy M., Curtis, Anne B., Stough, Wendy Gattis, Gheorghiade, Mihai, Heywood, J. Thomas, McBride, Mark L., Inge, Patches Johnson, Mehra, Mandeep R., O'Connor, Christopher M., Reynolds, Dwight, Walsh, Mary Norine, Yancy, Clyde W.·2010·Circulation
DOI 10.1161/circulationaha.109.934471
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Abstract

Background— A treatment gap exists between heart failure (HF) guidelines and the clinical care of patients. The Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) prospectively tested a multidimensional practice-specific performance improvement intervention on the use of guideline-recommended therapies for HF in outpatient cardiology practices. Methods and Results— Performance data were collected in a random sample of HF patients from 167 US outpatient cardiology practices at baseline, longitudinally after intervention at 12 and 24 months, and in single-point-in-time patient cohorts at 6 and 18 months. Participants included 34 810 patients with reduced left ventricular ejection fraction (≤35%) and chronic HF or previous myocardial infarction. To quantify guideline adherence, 7 quality measures were assessed. Interventions included clinical decision support tools, structured improvement strategies, and chart audits with feedback. The performance improvement intervention resulted in significant improvements in 5 of 7 quality measures at the 24-month assessment compared with baseline: β-blocker (92.2% versus 86.0%, +6.2%), aldosterone antagonist (60.3% versus 34.5%, +25.1%), cardiac resynchronization therapy (66.3% versus 37.2%, +29.9%), implantable cardioverter-defibrillator (77.5% versus 50.1%, +27.4%), and HF education (72.1% versus 59.5%, +12.6%) (each P <0.001). There were no statistically significant improvements in angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use or anticoagulation for atrial fibrillation. Sensitivity analyses at the patient level and limited to patients with both baseline and 24-month quality measure data yielded similar results. Improvements in the single-point-in-time cohorts were smaller, and there were no concurrent control practices. Conclusions— The Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting, a defined and scalable practice-specific performance improvement intervention, was associated with substantial improvements in the use of guideline-recommended therapies in eligible patients with HF in outpatient cardiology practices. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00303979.

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Metadata

Authors
Fonarow, G. C., Albert, N. M., Curtis, A. B., Stough, W. G., Gheorghiade, M., Heywood, J. T., McBride, M. L., Inge, P. J., Mehra, M. R., O'Connor, C. M., Reynolds, D., Walsh, M. N., & Yancy, C. W.
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-08-10
Volume
122
Issue
6
Pages
585-596
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.109.934471
OpenAlex
W2023603860
Cited by
425
References
2
FWCI
23.10
Type
journal article
Language
en
Open access
closed

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