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Heart failure performance measures: eligibility and implementation in the community.
Cecilia Berardi1, Alanna M Chamberlain, Francesca Bursi
1Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
American Heart Journal
|July 3, 2013
Summary
Performance measures for heart failure (HF) can be improved in community settings. However, most hospitalized patients don't meet criteria for current measures, necessitating new strategies for better care.
Area of Science:
- Cardiology
- Health Services Research
- Quality Improvement
Background:
- Heart failure (HF) performance measures aim to enhance care quality by evaluating guideline adherence in eligible patients.
- Limited data exists on the proportion of eligible HF patients and the community-level implementation of these measures.
Purpose of the Study:
- To assess the eligibility for and adherence to HF performance measures and beta-blocker therapy in a community-based hospitalized patient cohort.
- To identify gaps in the implementation of evidence-based therapies for heart failure.
Main Methods:
- Retrospective cohort study of hospitalized heart failure patients from January 2005 to June 2011.
- Determined eligibility and documented receipt of key therapies including beta-blockers, ACE inhibitors/ARBs, warfarin, and smoking cessation counseling.
Main Results:
- All 465 patients had ejection fraction assessed; only 164 (35%) had ejection fraction <40% and were candidates for beta-blockers and ACE inhibitors/ARBs.
- Among eligible patients, 85% received ACE inhibitors/ARBs and 91% received beta-blockers.
- Warfarin uptake was 54% among eligible atrial fibrillation patients, and 69% of smokers received cessation counseling.
Conclusions:
- Implementation of heart failure performance measures in community settings requires improvement.
- The majority of hospitalized heart failure patients are not candidates for current performance measures, indicating a need for alternative approaches to enhance care and outcomes.
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