Adherence to Guideline-Directed Stroke Prevention Therapy for Atrial Fibrillation Is Achievable.

Administration, Oral Aged Aged, 80 and over Anticoagulants / therapeutic use Atrial Fibrillation / drug therapy Female Guideline Adherence Humans Male Odds Ratio Patient Discharge Quality Improvement Registries Severity of Illness Index Stroke / prevention & control Treatment Outcome
atrial fibrillation guideline adherence measures outcomes

Journal

Circulation
ISSN: 1524-4539
Titre abrégé: Circulation
Pays: United States
ID NLM: 0147763

Informations de publication

Date de publication:
19 03 2019
Historique:
pubmed: 1 2 2019
medline: 31 12 2019
entrez: 1 2 2019
Statut: ppublish

Résumé

Efforts to improve prescription of oral anticoagulation (OAC) drugs in patients with atrial fibrillation have had limited success in improving guideline adherence. We evaluated adherence to the American College of Cardiology/American Heart Association performance measures for OAC in eligible patients with a CHA The median (25th, 75th percentile) age was 73 years (65, 81 years); 51% were female; and the median (25th, 75th percentile) CHA Among hospitals participating in the GWTG-AFIB quality improvement program, OAC prescription at discharge in eligible guideline-indicated patients increased significantly and improved consistently over time. These data confirm that high-level adherence to guideline-recommended stroke prevention is achievable.

Sections du résumé

BACKGROUND
Efforts to improve prescription of oral anticoagulation (OAC) drugs in patients with atrial fibrillation have had limited success in improving guideline adherence.
METHODS
We evaluated adherence to the American College of Cardiology/American Heart Association performance measures for OAC in eligible patients with a CHA
RESULTS
The median (25th, 75th percentile) age was 73 years (65, 81 years); 51% were female; and the median (25th, 75th percentile) CHA
CONCLUSIONS
Among hospitals participating in the GWTG-AFIB quality improvement program, OAC prescription at discharge in eligible guideline-indicated patients increased significantly and improved consistently over time. These data confirm that high-level adherence to guideline-recommended stroke prevention is achievable.

Identifiants

DOI: 10.1161/CIRCULATIONAHA.118.035909 PMID: 30700141
pubmed: 30700141
doi: 10.1161/CIRCULATIONAHA.118.035909
doi:

Substances chimiques

Anticoagulants 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1497-1506

Auteurs

Jonathan P Piccini (JP)

Duke Clinical Research Institute and Duke University Medical Center, Durham, NC (J.P.P., H.X., M.C., R.A.M.).

Haolin Xu (H)

Duke Clinical Research Institute and Duke University Medical Center, Durham, NC (J.P.P., H.X., M.C., R.A.M.).

Margueritte Cox (M)

Duke Clinical Research Institute and Duke University Medical Center, Durham, NC (J.P.P., H.X., M.C., R.A.M.).

Roland A Matsouaka (RA)

Duke Clinical Research Institute and Duke University Medical Center, Durham, NC (J.P.P., H.X., M.C., R.A.M.).

Gregg C Fonarow (GC)

Ronald Reagan-UCLA Medical Center, University of California, Los Angeles (G.C.F.).

Javed Butler (J)

Stony Brook University School of Medicine, NY (J.B.).

Anne B Curtis (AB)

University at Buffalo, NY (A.B.C.).

Nihar Desai (N)

Yale University, New Haven, CT (N.D.).

Margaret Fang (M)

University of California, San Francisco (M.F.).

Pamela J McCabe (PJ)

Mayo Clinic, Rochester, MN (P.J.M.).

Robert L Page Ii (RL)

University of Colorado Skaggs School of Pharmacy, Aurora (R.L.P.).

Mintu Turakhia (M)

VA Palo Alto Health Care System and Stanford University School of Medicine, CA (M.T.).

Andrea M Russo (AM)

Cooper University Hospital, Camden, NJ (A.M.R.).

Bradley P Knight (BP)

Feinberg School of Medicine, Northwestern University, Chicago, IL (B.P.K.).

Mandeep Sidhu (M)

Albany Medical Center, NY (M.S.).

Jodie L Hurwitz (JL)

North Texas Heart Center, Dallas (J.L.H.).

Kenneth A Ellenbogen (KA)

Virginia Commonwealth University, Richmond (K.A.E.).

William R Lewis (WR)

MetroHealth System Campus, Case Western Reserve University, Cleveland, OH (W.R.L.).

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Classifications MeSH

questionsmedicales.fr › Thérapeutique › Traitement médicamenteux › Voies d'administration de substances chimiques et des médicaments › Administration par voie orale › Adherence to Guideline-Directed Stroke...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Adherence to Guideline-Directed Stroke...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Sujet âgé de 80 ans ou plus › Adherence to Guideline-Directed Stroke...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents hématologiques › Anticoagulants › Adherence to Guideline-Directed Stroke...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Fibrillation auriculaire › Adherence to Guideline-Directed Stroke...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Adhésion aux directives › Adherence to Guideline-Directed Stroke...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Adherence to Guideline-Directed Stroke...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Odds ratio › Adherence to Guideline-Directed Stroke...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Continuité des soins › Sortie du patient › Adherence to Guideline-Directed Stroke...
questionsmedicales.fr › Administration des services de santé › Amélioration de la qualité › Adherence to Guideline-Directed Stroke...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enregistrements › Adherence to Guideline-Directed Stroke...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enquêtes et questionnaires › Enquêtes de santé › Indicateurs d'état de santé › Acuité des besoins du patient › Indice de gravité de la maladie › Adherence to Guideline-Directed Stroke...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Adherence to Guideline-Directed Stroke...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Adherence to Guideline-Directed Stroke...