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Updated: Aug 19, 2025

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Achalasia Quality Indicator Adherence.

Emily Romanoff1, Justin Zhuo2, Annsa C Huang3

  • 1Department of Internal Medicine, Duke University School of Medicine, Durham, NC, 27708, USA.

Digestive Diseases and Sciences
|December 2, 2022
PubMed
Summary

Quality indicators for achalasia management show 86% adherence overall, but patient education on treatment risks needs improvement. This study identifies key areas for enhancing achalasia care quality.

Keywords:
AchalasiaClinical practiceEsophageal motilityQuality indicators

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Area of Science:

  • Gastroenterology
  • Health Services Research
  • Quality Improvement

Background:

  • Quality indicators (QIs) are crucial for monitoring healthcare performance and identifying care delivery gaps.
  • Twelve QIs were developed for achalasia management, focusing on patient education, diagnosis, and treatment.
  • Achalasia management quality was assessed using these developed indicators.

Purpose of the Study:

  • To evaluate adherence to established quality indicators for achalasia management.
  • To identify specific areas of care delivery for achalasia patients that require improvement.
  • To provide a basis for developing fully specified quality measures for achalasia.

Main Methods:

  • Retrospective, multicenter evaluation of adult patients (≥18 years) with newly diagnosed achalasia (Jan 2018 - May 2020).
  • Random patient sampling from four academic medical centers with chart abstraction using standardized forms.
  • Analysis of pooled, de-identified electronic health record data to determine QI adherence and care gaps.

Main Results:

  • Overall adherence to applicable quality indicators was 86% across 120 patients.
  • Clinicians fully adhered to all applicable QIs in only 39% of cases.
  • Patient education had the lowest adherence (67%), with 50% lacking documented discussions on GERD risks post-myotomy.

Conclusions:

  • Gaps in achalasia care quality were identified, particularly in patient education regarding treatment risks.
  • Findings suggest a need for future quality improvement initiatives in achalasia management.
  • The study provides a foundation for developing comprehensive and specific quality measures for achalasia care.