Effectiveness of Data-Driven Quality Improvement on Hospitalizations and Health Outcomes for People With Coronary Heart Disease in Primary Care (QUEL): A Cluster Randomized Controlled Trial With 24-Month Follow-Up
Primary result · Proportion of participants who had unplanned cardiovascular disease hospitalizationsResult — go to the resultRelative risk 0.91 95% CI 0.75–1.10Authors' conclusion
A primary care, data-driven quality improvement program did not improve unplanned hospitalizations, MACE, medication prescriptions, achievement of risk factor targets, or management planning for people with CHD. Robust evidence for the use of a data-driven, collaborative approach to improving care for people with CHD in primary care remains elusive.
Study context
- Population
- Adults with coronary heart disease (CHD) (who visited their general practitioner in the past 12 months) in Australian primary care practicespatient cohort from 51 primary care practices
- Participants
- 7,864 adults
- Comparison
- Data-driven quality improvement program vs standard care
- Primary endpoint
- Proportion of participants who had unplanned cardiovascular disease hospitalizations
- Follow-up
- 24 months
Methodological detailsAustralian primary care practices (2019-2022), practices randomized; adults with CHD units of analysis, data extracted from electronic records linked to administrative data
- Australian primary care practices (2019-2022)
- Practices randomized; adults with CHD units of analysis
- Data extracted from electronic records linked to administrative data
Primary result
As reported in the abstract
Relative risk
0.91
95% CI 0.75–1.10
Intervention vs control
relative risk 0.91 (95% CI 0.75–1.10)
Secondary outcomes
| Outcome | Relative risk (95% CI) | |
|---|---|---|
| Secondary outcomes: MACE, medication prescriptions, risk factor targets, management planning · 24 monthsIntervention vs control · MACE · no significant difference between the groups | 0.81 (0.61–1.07) | |
| Secondary outcomes: MACE, medication prescriptions, risk factor targets, management planning · 24 monthsIntervention vs control · prescription of antiplatelet · no significant difference between the groups | 0.94 (0.79–1.13) | |
| Secondary outcomes: MACE, medication prescriptions, risk factor targets, management planning · 24 monthsIntervention vs control · statin · no significant difference between the groups | 1.03 (0.97–1.09) | |
| Secondary outcomes: MACE, medication prescriptions, risk factor targets, management planning · 24 monthsIntervention vs control · no significant difference between the groups | 1.00 (0.93–1.07) | |
| Secondary outcomes: MACE, medication prescriptions, risk factor targets, management planning · 24 monthsIntervention vs control · risk factor target for low-density lipoprotein cholesterol · no significant difference between the groups | 0.99 (0.86–1.13) | |
| Secondary outcomes: MACE, medication prescriptions, risk factor targets, management planning · 24 monthsIntervention vs control · systolic blood pressure · no significant difference between the groups | 0.97 (0.87–1.09) | |
| Secondary outcomes: MACE, medication prescriptions, risk factor targets, management planning · 24 monthsIntervention vs control · smoking · no significant difference between the groups | 0.96 (0.57–1.59) | |
| Secondary outcomes: MACE, medication prescriptions, risk factor targets, management planning · 24 monthsIntervention vs control · management planning · no significant difference between the groups | 1.02 (0.64–1.63) | |
| 0.512Relative risk (log scale) |
- Secondary outcomes: Major adverse cardiovascular events (MACE), medication prescriptions, risk factor targets, management planning: angiotensin-converting enzyme or angiotensin receptor blocker
Patient cohort characteristics
- Mean age (years)
- 71.9 (±11.8)
- Men
- 68%
- Prior myocardial infarction
- 24%
Original publication
Effectiveness of Data-Driven Quality Improvement on Hospitalizations and Health Outcomes for People With Coronary Heart Disease in Primary Care (QUEL): A Cluster Randomized Controlled Trial With 24-Month Follow-Up. Circ Popul Health Outcomes. Published 15 April 2026. doi:10.
Summarised from the published abstract; every number is checked against it