Heart failure & cardiomyopathies
Implementing a Cardiology Quality Incentive Program to Improve Guideline-Directed Medical Therapy
Main finding · Composite HFrEF therapy metricResult — go to the result2-year odds ratio 2.285 95% CI 1.653–3.158Authors' conclusion
Our program was associated with sustained improvements in GDMT adherence for CVD. It may serve as a scalable model for enhancing the quality of cardiovascular care.
Study context
- Population
- Cardiologists and their individualized cardiovascular disease (CVD) patient panels in ambulatory clinics of an academic health systemcardiologists across 15 ambulatory clinics
- Participants
- 54 cardiologists
- Comparison
- Monthly, 1-year, and 2-year changes in the odds of adhering to each specific metric associated with the implementation of the cardiovascular population health program
- Outcome
- Composite HFrEF therapy metric
- Follow-up
- 2 years
Methodological details15 ambulatory clinics, academic health system
- 15 ambulatory clinics
- Academic health system
Main finding
As reported in the abstract
2-year odds ratio
2.285
95% CI 1.653–3.158
P < 0.001
Further findings
Mineralocorticoid receptor antagonist · 2 years
| Comparison | 2-year OR (95% CI) | P value | |
|---|---|---|---|
| Cardiovascular population health programAfter vs before the intervention | 3.039 (2.520–3.663) | P < 0.001 | |
| 0.20.51252-year OR (log scale) |
Specified beta blockers · 2 years
| Comparison | 2-year OR (95% CI) | P value | |
|---|---|---|---|
| Cardiovascular population health programAfter vs before the intervention | 1.430 (1.129–1.810) | P = 0.003 | |
| 0.5122-year OR (log scale) |
Angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, or angiotensin receptor-neprilysin inhibitor therapy for heart failure with reduced ejection fraction (HFrEF) · 2 years
| Comparison | 2-year OR (95% CI) | P value | |
|---|---|---|---|
| Cardiovascular population health programAfter vs before the intervention | 1.228 (1.001–1.505) | P = 0.049 | |
| 0.5122-year OR (log scale) |
Statin or proprotein convertase subtilisin/kexin type 9 inhibitor therapy for atherosclerotic cardiovascular disease · 2 years
| Comparison | 2-year OR (95% CI) | P value | |
|---|---|---|---|
| Cardiovascular population health programAfter vs before the intervention | 1.146 (1.092–1.202) | P < 0.001 | |
| 0.5122-year OR (log scale) |
Blood pressure control · 2 years
| Comparison | 2-year OR (95% CI) | P value | |
|---|---|---|---|
| Cardiovascular population health programAfter vs before the intervention | 1.496 (1.444–1.550) | P < 0.001 | |
| 0.5122-year OR (log scale) |
Original publication
Summarised from the published abstract; every number is checked against it