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Influence of dedicated heart failure clinics on delivery of recommended therapies in outpatient cardiology practices: findings from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF).
Am Heart J. 2010 Feb; 159(2):238-44.AH

Abstract

BACKGROUND

National guidelines recommend heart failure (HF) disease management programs to facilitate adherence to evidence-based practices. This study examined the influence of dedicated HF clinics on delivery of guideline-recommended therapies for cardiology practice outpatients with HF and reduced left ventricular ejection fraction.

METHODS

IMPROVE HF, a prospective cohort study, enrolled 167 cardiology practices to characterize outpatient management of 15,381 patients with chronic systolic HF. Adherence to guideline-recommended HF therapies was recorded, and the presence of a dedicated HF clinic was assessed by survey. Multivariate models identified contributions to delivery of guideline-recommended HF therapies.

RESULTS

Of practices, 41.3% had a dedicated HF clinic. Practices with a dedicated HF clinic had greater adherence to 3 of 7 guideline-recommended HF therapy measures: angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (P = .02), beta-blocker (P = .025), and HF education (P = .009). After adjustment, use of a dedicated HF clinic was associated with greater conformity in 2 of 7 measures: cardiac resynchronization therapy (P = .036) and HF education (P = .005) but not angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, beta-blocker, aldosterone antagonist, implantable cardioverter-defibrillator therapy, and anticoagulation for atrial fibrillation.

CONCLUSIONS

Use of dedicated HF clinics varied in cardiology outpatient practices and was associated with greater use of cardiac resynchronization therapy and HF education but not other guideline-recommended therapies.

Authors+Show Affiliations

Nursing Institute and Kaufman Center for Heart Failure, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. albertn@ccf.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20152222

Citation

Albert, Nancy M., et al. "Influence of Dedicated Heart Failure Clinics On Delivery of Recommended Therapies in Outpatient Cardiology Practices: Findings From the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF)." American Heart Journal, vol. 159, no. 2, 2010, pp. 238-44.
Albert NM, Fonarow GC, Yancy CW, et al. Influence of dedicated heart failure clinics on delivery of recommended therapies in outpatient cardiology practices: findings from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF). Am Heart J. 2010;159(2):238-44.
Albert, N. M., Fonarow, G. C., Yancy, C. W., Curtis, A. B., Stough, W. G., Gheorghiade, M., Heywood, J. T., McBride, M., Mehra, M. R., O'Connor, C. M., Reynolds, D., & Walsh, M. N. (2010). Influence of dedicated heart failure clinics on delivery of recommended therapies in outpatient cardiology practices: findings from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF). American Heart Journal, 159(2), 238-44. https://doi.org/10.1016/j.ahj.2009.11.022
Albert NM, et al. Influence of Dedicated Heart Failure Clinics On Delivery of Recommended Therapies in Outpatient Cardiology Practices: Findings From the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF). Am Heart J. 2010;159(2):238-44. PubMed PMID: 20152222.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of dedicated heart failure clinics on delivery of recommended therapies in outpatient cardiology practices: findings from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF). AU - Albert,Nancy M, AU - Fonarow,Gregg C, AU - Yancy,Clyde W, AU - Curtis,Anne B, AU - Stough,Wendy Gattis, AU - Gheorghiade,Mihai, AU - Heywood,J Thomas, AU - McBride,Mark, AU - Mehra,Mandeep R, AU - O'Connor,Christopher M, AU - Reynolds,Dwight, AU - Walsh,Mary Norine, PY - 2009/10/16/received PY - 2009/11/24/accepted PY - 2010/2/16/entrez PY - 2010/2/16/pubmed PY - 2010/3/4/medline SP - 238 EP - 44 JF - American heart journal JO - Am Heart J VL - 159 IS - 2 N2 - BACKGROUND: National guidelines recommend heart failure (HF) disease management programs to facilitate adherence to evidence-based practices. This study examined the influence of dedicated HF clinics on delivery of guideline-recommended therapies for cardiology practice outpatients with HF and reduced left ventricular ejection fraction. METHODS: IMPROVE HF, a prospective cohort study, enrolled 167 cardiology practices to characterize outpatient management of 15,381 patients with chronic systolic HF. Adherence to guideline-recommended HF therapies was recorded, and the presence of a dedicated HF clinic was assessed by survey. Multivariate models identified contributions to delivery of guideline-recommended HF therapies. RESULTS: Of practices, 41.3% had a dedicated HF clinic. Practices with a dedicated HF clinic had greater adherence to 3 of 7 guideline-recommended HF therapy measures: angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (P = .02), beta-blocker (P = .025), and HF education (P = .009). After adjustment, use of a dedicated HF clinic was associated with greater conformity in 2 of 7 measures: cardiac resynchronization therapy (P = .036) and HF education (P = .005) but not angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, beta-blocker, aldosterone antagonist, implantable cardioverter-defibrillator therapy, and anticoagulation for atrial fibrillation. CONCLUSIONS: Use of dedicated HF clinics varied in cardiology outpatient practices and was associated with greater use of cardiac resynchronization therapy and HF education but not other guideline-recommended therapies. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/20152222/Influence_of_dedicated_heart_failure_clinics_on_delivery_of_recommended_therapies_in_outpatient_cardiology_practices:_findings_from_the_Registry_to_Improve_the_Use_of_Evidence_Based_Heart_Failure_Therapies_in_the_Outpatient_Setting__IMPROVE_HF__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(09)00902-8 DB - PRIME DP - Unbound Medicine ER -