Heart failure performance measures: eligibility and implementation in the community.
Heart failure performance measures: eligibility and implementation in the community.
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DOI：
10.1016/j.ahj.2013.03.008
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发表时间：
2013-07
影响因子：
4.8
通讯作者：
Roger, Veronique L.
中科院分区：
文献类型：
--
作者：
Berardi, Cecilia;Chamberlain, Alanna M.;Bursi, Francesca;Redfield, Margaret M.;McNallan, Sheila M.;Weston, Susan A.;Jiang, Ruoxiang;Roger, Veronique L.
心力衰竭（HF）性能指标的目标是通过评估指南在合格患者中的实施情况来提高护理质量。对于符合条件的患者比例以及如何在社区中实施绩效措施知之甚少。我们确定了2005年1月至2011年6月期间住院HF患者的社区队列中性能指标和β受体阻滞剂治疗的合格性和依从性。所有465例HF住院患者（中位年龄76岁，48%为男性）均接受了射血分数（EF）评估。只有164例EF<40%，因此可作为β受体阻滞剂和血管紧张素转换酶（ACE）抑制剂或血管紧张素受体阻滞剂（ARB）治疗的候选者。考虑到绝对禁忌症，99例患者有资格接受ACE抑制剂/ARB，162例患者有资格接受β受体阻滞剂。其中，85%接受ACE抑制剂/ARB，91%接受β受体阻滞剂。在261名房颤患者中，89人符合华法林治疗条件，54%的患者接受了华法林治疗。在52名目前吸烟的患者中，69%的患者在住院期间接受了戒烟咨询。在社区中，在符合条件的住院HF患者中，可以改善绩效指标的实施。然而，由于大多数患者不是当前性能指标的候选人，因此需要其他方法来改善护理和结果。
The goal of heart failure (HF) performance measures is to improve quality of care by assessing the implementation of guidelines in eligible patients. Little is known about the proportion of eligible patients and how performance measures are implemented in the community. We determined the eligibility for and adherence to performance measures and beta-blocker therapy in a community-based cohort of hospitalized HF patients from 1/2005-6/2011. All of the 465 HF inpatients (median age 76 years, 48% men) included in the study received an ejection fraction (EF) assessment. Only 164 had an EF<40% thus were candidates for beta-blocker and angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blocker (ARB) therapy. Considering absolute contraindications, 99 patients were eligible to receive ACE inhibitors/ARB, and 162 to receive beta-blockers. Among these, 85% received ACE inhibitors/ARBs and 91% received beta-blockers. Among the 261 individuals with atrial fibrillation, 89 were eligible for warfarin and 54% received it. Of 52 current smokers, 69% received cessation counseling during hospitalization. In the community, among eligible hospitalized HF patients, the implementation of performance measures can be improved. However, as most patients are not candidates for current performance measures, other approaches are needed to improve care and outcomes.
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影响因子：
37.8
作者：
Roger VL;Go AS;Lloyd-Jones DM;Benjamin EJ;Berry JD;Borden WB;Bravata DM;Dai S;Ford ES;Fox CS;Fullerton HJ;Gillespie C;Hailpern SM;Heit JA;Howard VJ;Kissela BM;Kittner SJ;Lackland DT;Lichtman JH;Lisabeth LD;Makuc DM;Marcus GM;Marelli A;Matchar DB;Moy CS;Mozaffarian D;Mussolino ME;Nichol G;Paynter NP;Soliman EZ;Sorlie PD;Sotoodehnia N;Turan TN;Virani SS;Wong ND;Woo D;Turner MB;American Heart Association Statistics Committee and Stroke Statistics Subcommittee
通讯作者：
American Heart Association Statistics Committee and Stroke Statistics Subcommittee
影响因子：
3
作者：
Patterson ME;Hernandez AF;Hammill BG;Fonarow GC;Peterson ED;Schulman KA;Curtis LH
通讯作者：
Curtis LH
影响因子：
4.2
作者：
Rosenman, Marc B.;Simon, Teresa A.;Jackson, Joseph D.
通讯作者：
Jackson, Joseph D.
影响因子：
24
作者：
Piccini, Jonathan P.;Hernandez, Adrian F.;Fonarow, Gregg C.
通讯作者：
Fonarow, Gregg C.
DOI：
10.1161/circoutcomes.109.879478
发表时间：
2010-05-01
影响因子：
6.9
作者：
Peterson, Pamela N.;Rumsfeld, John S.;Masoudi, Frederick A.
通讯作者：
Masoudi, Frederick A.