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Defining quality indicators for atherosclerotic cardiovascular diseases in primary care, extractable from the

Laura Christiaens1, Willem Raat2, Liesbeth Meel3

  • 1Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 7 bus 7001 blok h, Leuven, 3000, Belgium. laura.christiaens@kuleuven.be.

BMC Primary Care
|November 29, 2025
PubMed

Insights

This study developed 41 quality indicators (QIs) for atherosclerotic cardiovascular diseases (ASCVD) in primary care. These electronic health record (EHR) extractable QIs will support audit and feedback (A&F) to improve ASCVD management.

Area of Science:

  • Cardiovascular Medicine
  • Health Services Research
  • Primary Care Quality Improvement

Background:

  • Atherosclerotic cardiovascular diseases (ASCVD) represent a significant global health burden, accounting for 85% of all cardiovascular diseases.
  • General practitioners are pivotal in managing ASCVD, with potential for improved care through audit and feedback (A&F).
  • Electronic health records (EHRs) offer a data source for quality indicators (QIs) to drive A&F in primary care settings.

Purpose of the Study:

  • To define a validated set of QIs for ASCVD management.
  • To ensure these QIs are extractable from general practitioner EHRs.
  • To facilitate A&F initiatives aimed at enhancing ASCVD care in primary care.

Main Methods:

  • A RAND-modified Delphi method was utilized to develop the QIs.
  • Recommendations were sourced from international guidelines, evaluated using AGREE II, and assessed by a multidisciplinary expert panel.
  • Consensus meetings and Likert scale scoring were employed for validation and classification of potential QIs.

Main Results:

  • A total of 92 recommendations were initially evaluated, leading to 50 high-potential candidates.
  • Following a consensus meeting, recommendations were refined into 41 final QIs.
  • The 41 QIs are categorized into follow-up (4), pharmacological treatment (22), patient education (10), and referral (5).

Conclusions:

  • A validated set of 41 EHR-extractable QIs for ASCVD has been established for primary care.
  • These QIs provide a foundation for implementing audit and feedback (A&F) programs.
  • The defined QIs aim to improve the quality of ASCVD care delivered in primary care settings.
Abstract

Keywords:
ConsensusDelphi TechniqueFeedbackPopulation health managementQuality improvementQuality indicators

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